title: Preoperative evaluation of coronary artery fistula using dual-source computed tomography.
abstract: OBJECTIVE
  To evaluate the efficacy of dual-source computed tomography (DSCT) in assessing the morphological features, quantitative features, and associated coronary artery lesions among patients with coronary artery fistula (CAF) before surgery.
  
  
  METHODS
  We enrolled 34 patients with CAF that were morphologically and quantitatively analyzed by DSCT and compared the analyses with surgical results (reference standard). The associated coronary artery lesions were also assessed.
  
  
  RESULTS
  By DSCT, we identified 15 patients (44.1%) with left-sided CAF, 9 (26.5%) with right-sided CAF, and 10 (29.4%) with bilateral CAF; the left anterior descending coronary artery (50.0%) was most frequently involved. Drainage was most commonly in the main pulmonary artery (41.2%), and those with right-sided CAF had larger feeding coronary arteries and drainage sites than those with left-sided or bilateral CAF (p<0.05). All the morphological features presented by DSCT were confirmed at surgery. In the quantitative analysis of CAF, DSCT was as accurate as surgery (r=0.95-0.98, p<0.001), and it was able to evaluate associated lesions accurately, including arteriosclerotic plaques, coronary artery aneurysms, and myocardial bridges. The evaluation could be completed in a single scan, without requiring an increased radiation dose (mean ED=2.27±1.92mSv).
  
  
  CONCLUSIONS
  DSCT is an alternative noninvasive imaging method that enables accurate assessment of morphological features, quantitative features, and associated coronary artery lesions in patients with CAF. It can be used to provide comprehensive information for determining surgical strategies.
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Shi
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: Hong-Ling
authors.initials: HL
authors.lastname: Gao
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China. Electronic address: yangzg666@163.com.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Yang
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, Sichuan 610041, China. Electronic address: gykpanda@163.com.
authors.forename: Ying-Kun
authors.initials: YK
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D001159:Arterio-Arterial Fistula / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D002681:China; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000379:methods
keywords: Computed tomography; Congenital heart disease; Coronary artery fistula