Imaging of coronary artery anomalies: the role of multidetector computed tomography.
BACKGROUND
Coronary artery anomalies are evaluated by using catheter-based angiography. Multidetector row-computed tomography (MDCT) is a new noninvasive imaging technique that has excellent spatial resolution for detecting the origin and course of a coronary anomalous vessel.


OBJECTIVE
To determine the sensitivity of multidetector computed tomography in patients who had coronary artery anomaly demonstrated by conventional coronary angiography.


METHODS
A retrospective evaluation to identify 23 patients, who underwent retrospective electrocardiographic (ECG)-gated MDCT, was done and in whom an anomalous coronary vessel was found at a single center. Metoprolol (50-100 mg) was given orally to all patients to reduce heart rate so as to get high-quality MDCT images. After performing MDCT, the CT scans of each patient were analysed and compared with their coronary angiograms by two experienced radiologists and one cardiologist who were unaware about the study, and the sensitivity of MDCT was determined.


RESULTS
Twenty-three patients (age range 28-73) with seven different coronary arteries of the anomalous type were evaluated. Nineteen patients had an anomalous left coronary artery; three patients had an anomalous single coronary artery; and one patient had an anomalous right coronary artery. The most common anomaly type was the left circumflex coronary artery (52%). The origin and course of all anomalous vessels were detected by ECG-gated MDCT (Lightspeed 16, GE Medical Systems, Milwaukee, Wisconsin, USA). The sensitivity of 100% of MDCT was detected in patients who had anomalous coronary vessels.


CONCLUSIONS
We suggest that MDCT could be a non-invasive alternative imaging technique to conventional coronary angiography for screening the anomalous vessels of coronary arteries because of its excellent spatial resolution, which is very important for detecting the relationship of anomalous vessels with great arteries and cardiac structures.
Kacmaz
Fehmi
F
Cardiology Clinics, Turkish Society of Cardiology, Ankara, Turkey. kacmazfehmi@superonline.com
Ozbulbul
Nilgun Isiksalan
NI
Alyan
Omer
O
Maden
Orhan
O
Demir
Ahmet Duran
AD
Balbay
Yucel
Y
Erbay
Ali Riza
AR
Atak
Ramazan
R
Senen
Kubilay
K
Olcer
Tulay
T
Ilkay
Erdogan
E
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*