Diagnostic Value Of Dual-source CT Coronary Angiography In Patients With Congenital Coronary Artery Anomalies

Objective:To evaluate the diagnostic value of dual-source CT coronaryangiography (DSCT-CA) in patients with congenital coronary arteryanomalies．Materials and Methods:We reviewed12145patients with suspected coronary arterial disease (CAD)underwent DSCT-CA at our institution. Curved multiplanar reformation (CPR),maximum-intensity-projection (MIP), and volume-rendered (VR) were performed onan off-line workstation.Each study was assessed retrospectively for the origin and course of theanomalous coronary artery by a minimum of two cardio-vascular radiologists,decisions were made in consensus.Results:There were124patients (1.02%) with coronary anomalies. Fifty-one patientsdemonstrated an anomalous origin of the right coronary artery from the left sinus ofValsalva or the left main artery (LM). An anomalous origin of a left circumflexartery (LCX) from the right sinus of Valsalva or the right coronary artery (RCA) wasdepicted in17patients. An anomalous origin of a left main artery (LM) from theright sinus of Valsalva was depicted in one patient. A single coronary artery wasshown in4patients and congenital transposition of the great arteries was associatedwith this anomaly in one patient. In the remaining50patients, coronary artery fistulas were identified. Eight patients were referred after an equivocal conventionalcoronary angiography.Conclusion:DSCT-CA is recommended as the first-line non-invasive diagnostic tool thatallows to accurately delineate coronary arterial anomalies in an appropriate clinicalsetting, provides detailed three-dimensional anatomic information that may bedifficult to obtain with invasive coronary angiography.