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Multidetector computed tomography imaging of coronary artery anomalies

Published online by Cambridge University Press:  19 October 2012

Aysel Türkvatan ,
Yeşim Güray  and
Dilek Altınsoy
Aysel Türkvatan*
Affiliation:
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
Yeşim Güray
Affiliation:
Department of Cardiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
Dilek Altınsoy
Affiliation:
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
*
Correspondence to: Dr A. Türkvatan, Radiologist, MD, Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay Street, No. 4, 06100 Sıhhiye, Ankara, Turkey. Tel: 90 312 3061671; Fax: 90 312 3124120; E-mail: aturkvatan@yahoo.com
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Abstract

Purpose

The purpose of the study was to determine the prevalence of coronary artery anomalies and to demonstrate in which cases multidetector computed tomography has an additional clinical value compared with the conventional angiography.

Material and methods

A total of 2375 multidetector computed tomography studies were retrospectively reviewed to determine the dominance of the coronary artery anomalies. The classification of coronary artery anomalies was made according to anatomical criteria – origin, course, intrinsic anatomy, and termination – and clinical relevance – benign versus malignant.

Results

The coronary artery system was right dominant in 83.99%, left dominant in 8.0%, and co-dominant in 9.01% of the cases. The incidence of the origin and/or course anomalies was 1.76%, that of fistulas was 0.42%, and that of myocardial bridges was 10.82%. Multidetector computed tomography was performed after conventional angiography in 23 cases and it provided additional information regarding its origin and proximal course, as well as its relationship with the aortic root and main pulmonary trunk in 100% of the cases; eight malignant cases were found. In addition, in all of (100%) the six cases with coronary artery fistulas, conventional angiography failed to detect their terminations, which were clearly depicted by multidetector computed tomography.

Conclusion

Multidetector computed tomographic angiography is superior to conventional angiography in delineating the ostial origin and proximal course of anomalous coronary arteries. Furthermore, it reveals the exact relationship of anomalous coronary arteries with the aorta and the pulmonary artery. Anomalies of the intrinsic anatomy and the termination of coronary arteries are also better visualised with multidetector computed tomography.

Keywords

Coronary arteryanomaliesmultidetector computed tomographyangiography
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 5 , October 2013 , pp. 661 - 674
Copyright
Copyright © Cambridge University Press 2012 

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