title: Coronary artery fistulas in children. Evaluation with 64-slice multidetector CT.
abstract: OBJECTIVE
  There are various types of coronary artery fistulas (CAF) with complex shapes. Therefore, it is important to make a correct diagnosis and to understand the relationship of the CAF to the adjacent structures before transcatheter occlusion or surgery. This study evaluated the feasibility of using 64-slice multidetector computed tomography (MDCT) angiography in diagnosing CAF.
  
  
  METHODS
  Two readers who were blinded to the results of echocardiography, intervention, or surgery retrospectively evaluated the coronary MDCT appearances of CAF in 10 patients (4 boys and 6 girls; mean age, 2.9 years; range, 1-6 years). The origin, course, and distal entry site of the fistula were determined. The diameters of the origin and the distal entry site were measured and compared with those seen during intervention or surgery.
  
  
  RESULTS
  The origin, course, and distal vessel entry site of the CAF were clearly outlined in all patients by MDCT. The distal vessel draining site involved a single entry vessel in all patients. Seven fistulas involved the right coronary artery, and three involved the left coronary artery. Four fistulas drained into the right ventricle, four into the right atrium, and two into the left ventricle. The diagnosis of CAF using MDCT was in accordance with diagnoses made during intervention or surgery. There was an excellent correlation between MDCT and transcatheter occlusion in quantifying the diameters of the origin and distal entry site (R = 0.90 and 0.92, respectively, P < 0.05).
  
  
  CONCLUSIONS
  Coronary 64-slice MDCT angiography depicted the whole shape and course of the CAF as well as of the surrounding structures. It may serve as a noninvasive diagnostic tool when planning a therapeutic strategy.
authors.affiliation: Radiology Department, Children's Hospital of Fudan University Shanghai, Shanghai, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Hu
authors.forename: L
authors.initials: L
authors.lastname: Wu
authors.forename: F
authors.initials: F
authors.lastname: Liu
authors.forename: Q
authors.initials: Q
authors.lastname: Shen
authors.forename: M
authors.initials: M
authors.lastname: Pa
authors.forename: G
authors.initials: G
authors.lastname: Huang
mesh_terms: D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
references.citation: Rev Port Cardiol. 2011 Dec;30(12):891-6
references.pmid: 22112711
references.citation: Pediatr Cardiol. 2013 Mar;34(3):774-6
references.pmid: 23104593
references.citation: Pediatr Radiol. 2008 Jun;38(6):645-56
references.pmid: 18392817
references.citation: Br J Radiol. 2010 Feb;83(986):152-8
references.pmid: 20139263
references.citation: Chin Med J (Engl). 2010 Apr 5;123(7):838-42
references.pmid: 20497674
references.citation: AJR Am J Roentgenol. 2004 Mar;182(3):777-84
references.pmid: 14975985
references.citation: Ann Thorac Surg. 1997 May;63(5):1235-42
references.pmid: 9146308
references.citation: Pediatr Radiol. 2011 Feb;41(2):244-9
references.pmid: 20821005
references.citation: Echocardiography. 2006 Jan;23(1):62-4
references.pmid: 16412187
references.citation: Clin Cardiol. 2008 Jan;31(1):41-7
references.pmid: 18203118
references.citation: Eur Radiol. 2005 Jun;15(6):1110-21
references.pmid: 15756551
references.citation: J Am Coll Cardiol. 1992 Jul;20(1):205-9
references.pmid: 1607526
references.citation: Pediatr Radiol. 2008 Mar;38(3):325-7
references.pmid: 17985125
references.citation: Radiographics. 2009 May-Jun;29(3):781-9
references.pmid: 19448115
references.citation: J Am Coll Cardiol. 2002 Mar 20;39(6):1026-32
references.pmid: 11897446
references.citation: Br Heart J. 1993 Sep;70(3):272-3
references.pmid: 8398499
references.citation: Pediatr Radiol. 2010 Oct;40(10):1670-80
references.pmid: 20464385
references.citation: J Formos Med Assoc. 2010 Dec;109(12):907-12
references.pmid: 21195889
references.citation: Catheter Cardiovasc Interv. 2007 Jul 1;70(1):110-6
references.pmid: 17420995
references.citation: AJR Am J Roentgenol. 2009 Aug;193(2):539-44
references.pmid: 19620454
references.citation: J Comput Assist Tomogr. 2011 Sep-Oct;35(5):618-24
references.pmid: 21926859
references.citation: Circulation. 1979 May;59(5):849-54
references.pmid: 428095
references.citation: AJR Am J Roentgenol. 2005 Nov;185(5):1258-60
references.pmid: 16247146
references.citation: Clin Cardiol. 2001 Sep;24(9):630-2
references.pmid: 11558847
references.citation: Int J Cardiol. 2006 Feb 8;107(1):7-10
references.pmid: 16125261