title: Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography.
abstract: The objective of this study is to evaluate multidetector CT (MDCT) in detecting and characterizing anomalous coronary arteries. Forty-four patients with anomalies of the coronaries were selected from a total of 1758 individuals examined with ECG-gated 4- and 16-row MDCT including thinMIP, MPR and VRT post-processing. Twenty-eight patients showed origin and course anomalies of the central coronary segments, and in this subgroup 13 were judged as "malignant" because of interarterial courses between the aortic root and the pulmonary trunk, either of the right coronary artery (n=11) or the left coronary artery (n=2). Twelve non-hemodynamic anomalies were found, affecting the coronary origins only (n=10) or the peripheral vessels courses (n=2). Four arteriovenous fistulas were present, all of them with complex arterial feeders. Regardless of vessel anatomy, coronary opacification was always possible by means of the systemic contrast agent, and the aberrant coronary arteries were visualized synoptically in direct relation to the great mediastinal vessels. In contrast to MDCT, selective cannulation and final diagnosis was possible in only 11 of the 20 catheter angiograms performed (accuracy of 55.0%). In conclusion, its non-invasiveness and precise visualization makes MDCT the standard of reference for evaluating anomalous coronary arteries.
authors.affiliation: Department of Radiology, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale, Germany. schmitt.radiologie@herzchirurgie.de
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmitt
authors.forename: Steffen
authors.initials: S
authors.lastname: Froehner
authors.forename: Juergen
authors.initials: J
authors.lastname: Brunn
authors.forename: Matthias
authors.initials: M
authors.lastname: Wagner
authors.forename: Horst
authors.initials: H
authors.lastname: Brunner
authors.forename: Oleg
authors.initials: O
authors.lastname: Cherevatyy
authors.forename: Frank
authors.initials: F
authors.lastname: Gietzen
authors.forename: Georgios
authors.initials: G
authors.lastname: Christopoulos
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kerber
authors.forename: Franz
authors.initials: F
authors.lastname: Fellner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015994:Incidence; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol