Diagnosis of anomalous coronary arteries in 64-MDCT

Anomalous coronary arteries can be benign or life threatening. Novel advances on multi-detector computed tomography (MDCT) provide a noninvasive technique and offer an accurate diagnostic modality to visualize the origin and course of anomalous coronary arteries by a 3D display of anatomy. Thus we demonstrated anomalies of coronary arteries shown by 64-MDCT in our institution. 540 subjects referred to our Hospital for MDCT coronary angiography were included in this study. These subjects were between the ages of 12 and 90 years (mean 59±12.6 years) including 297 (55%) male and 243 (45%) female. Post-processing techniques such as volume rendering (VR) and maximum intensity projection (MIP) were applied to demonstrate the coronary artery anatomy. Both a radiologist and a cardiologist evaluated all examinations. The incidence of anomalous anatomical origin and course of the coronary arteries in our study group was 15% (n = 81). The anomalies found in our study are absence of left main coronary artery (n = 3, 0.5%), high take-off origin of left main coronary artery (n= 1, 0.2%), ectopic origin of right coronary artery from the left coronary sinus (n = 8, 1.5%), and myocardial bridging (n = 68, 12.6%). MDCT with VR and MIP techniques is practical for assessment of anomalous coronary arteries and helpful for radiologist, cardiologist and surgeon.