Imaging of coronary artery fistulas by multidetector computed tomography: is multidetector computed tomography sensitive?
BACKGROUND
Coronary angiography is the gold standard for diagnosing coronary artery fistulas (CAFs). Multidetector computed tomography (MDCT) is a recently developed imaging technique for detecting coronary artery stenosis, coronary artery anomalies, and coronary artery fistulas and their courses.


OBJECTIVE
We aimed to determine accuracy or sensitivity of MDCT in patients having CAF.


METHODS
We evaluated 13 patients with 15 CAFs detected earlier by coronary angiography. MDCT was carried out on all patients and the results were compared with coronary angiography, following which, sensitivity of MDCT was detected.


RESULTS
Eleven of 15 CAFs were shown on MDCT and the overall sensitivity of MDCT was found to be 73%. Seven of 8 CAFs that coursed between two vascular structures were detected and the sensitivity of MDCT in this group was found to be 87%. However, the sensitivity of 58% of MDCT in patients with fistula coursing between coronary arteries and cardiac chambers was found.


CONCLUSIONS
Although coronary angiography is the gold standard diagnostic test for detection of CAF, MDCT may be an alternative test, especially, for CAF coursing between vascular structures, to detect origin, course, and the drainage site of fistula through its excellent spatial resolution and ability to show relationship of anatomic structures.
Kacmaz
Fehmi
F
Cardiology Clinics, Turkish Society of Cardiology, Ankara, Turkey. kacmazfehmi@superonline.com
Isiksalan Ozbulbul
Nilgun
N
Alyan
Omer
O
Maden
Orhan
O
Demir
Ahmet Duran
AD
Atak
Ramazan
R
Senen
Kubilay
K
Erbay
Ali Riza
AR
Balbay
Yucel
Y
Olcer
Tulay
T
Ilkay
Erdogan
E
D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016157:Vascular Fistula / Q000000981:diagnostic imaging*