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Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography

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Abstract

The objective of this study is to evaluate multidetector CT (MDCT) in detecting and characterizing anomalous coronary arteries. Forty-four patients with anomalies of the coronaries were selected from a total of 1758 individuals examined with ECG-gated 4- and 16-row MDCT including thinMIP, MPR and VRT post-processing. Twenty-eight patients showed origin and course anomalies of the central coronary segments, and in this subgroup 13 were judged as “malignant” because of interarterial courses between the aortic root and the pulmonary trunk, either of the right coronary artery (n=11) or the left coronary artery (n=2). Twelve non-hemodynamic anomalies were found, affecting the coronary origins only (n=10) or the peripheral vessels courses (n=2). Four arteriovenous fistulas were present, all of them with complex arterial feeders. Regardless of vessel anatomy, coronary opacification was always possible by means of the systemic contrast agent, and the aberrant coronary arteries were visualized synoptically in direct relation to the great mediastinal vessels. In contrast to MDCT, selective cannulation and final diagnosis was possible in only 11 of the 20 catheter angiograms performed (accuracy of 55.0%). In conclusion, its non-invasiveness and precise visualization makes MDCT the standard of reference for evaluating anomalous coronary arteries.

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Authors and Affiliations

  1. Department of Radiology, Herz- und Gefaessklinik GmbH, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany

    Rainer Schmitt, Steffen Froehner, Matthias Wagner, Horst Brunner, Oleg Cherevatyy & Georgios Christopoulos

  2. Department of Cardiology, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale, Germany

    Juergen Brunn, Frank Gietzen & Sebastian Kerber

  3. Department of Radiology, Oberoesterreichische Landesnervenklinik, Linz, Austria

    Franz Fellner

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  1. Rainer Schmitt
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  2. Steffen Froehner
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  3. Juergen Brunn
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Correspondence to Rainer Schmitt.

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Schmitt, R., Froehner, S., Brunn, J. et al. Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography. Eur Radiol 15, 1110–1121 (2005). https://doi.org/10.1007/s00330-005-2707-z

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  • DOI: https://doi.org/10.1007/s00330-005-2707-z

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