title: Remarkable anatomic anomalies of coronary arteries and their clinical importance: a multidetector computed tomography angiographic study.
abstract: OBJECTIVE
  An anomalous origin and course of the coronary arteries can be benign or life threatening. Recently, because of new advances in computed tomography technology, radiologists have begun to interpret the diseases of coronary arteries. We aimed to demonstrate some remarkable anomalies of coronary arteries, some of which were not shown by multidetector computed tomography (MDCT) coronary angiography previously, and to discuss the clinical importance of these anomalies.
  
  
  METHODS
  Seven hundred twenty-five consequent patients referred to Florence Nightingale Hospital and Atatürk University Hospital for MDCT coronary angiography were included in this study. The patients were between the ages of 33 and 78 years (mean +/- SD, 59 +/- 13.86 years). Four hundred ninety-seven patients (68.6%) were men, and 228 (31.4%) were women. All the examinations were evaluated by both a radiologist and a cardiologist.
  
  
  RESULTS
  The incidence of anomalous anatomical origin and course of the coronaries found in our study group was 5.79% (n = 42). The anomalies found in our study are absence of the right coronary artery (RCA; n = 1, 0.13%), ectopic origin of RCA from the left anterior descending (LAD) artery (n = 1, 0.13%), absence of the left main coronary artery (n = 4, 0.52%), ectopic origin of the left main coronary artery from the right sinus of Valsalva (n = 1, 0.13%), double LAD and ectopic origin of LAD from RCA (n = 1, 0.13%), ectopic origin of the left circumflex artery from the right sinus of Valsalva (n = 3, 0.39%), ectopic origin of the left circumflex artery from RCA (n = 2, 0.26%), and myocardial bridging (n = 29, 4%).
  
  
  CONCLUSIONS
  An anomalous origin of the coronary anatomy must be present in the interpretations because of its importance for patients, cardiologists, and surgeons. As a conclusion, our study showed that MDCT, especially volume rendering and maximum intensity projection techniques, may be useful for assessment of complex variations, when the conventional angiography may not be sufficient.
authors.affiliation: Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Duran
authors.forename: Mecit
authors.initials: M
authors.lastname: Kantarci
authors.forename: Irmak
authors.initials: I
authors.lastname: Durur Subasi
authors.forename: Murat
authors.initials: M
authors.lastname: Gulbaran
authors.forename: Serdar
authors.initials: S
authors.lastname: Sevimli
authors.forename: Ednan
authors.initials: E
authors.lastname: Bayram
authors.forename: Suat
authors.initials: S
authors.lastname: Eren
authors.forename: Adem
authors.initials: A
authors.lastname: Karaman
authors.forename: Fadime
authors.initials: F
authors.lastname: Fil
authors.forename: Adnan
authors.initials: A
authors.lastname: Okur
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed