Imaging of coronary artery anomalies using ECG-gated 64-row computed tomography angiography

ObjectiveTo shed light on coronary artery anomalies among cardiac patients using ECG-gated 64-row MDCTA during assessment of coronary arteries.Patients and methodsStudy included 840 patients out of whom twenty-one patients have congenital coronary artery anomalies. Patients were examined using ECG gated 64-row MDCT; 80–100 ml contrast agent, followed by a 50 ml saline chaser injected at 5 ml/s, 350 ms gantry rotation time, 0.65 mm detector collimation, ECG tube current modulation and 100–120 kV. Post-processing was done on second workstation including 3D VR, MPR and CMPR images.ResultsAnomalies of the coronary arteries were diagnosed in twenty-one patients. The prevalence of congenital anomalies in this study was 2.5% and included: anomalous origin of right coronary artery in 4 cases (0.48%), anomalous origin of left circumflex artery in 3 cases (0.36%), myocardial bridging of LAD in 12 cases (1.4%) and coronary artery fistula in 2 cases (0.24%).ConclusionCoronary artery anomalies are not uncommon among cardiac patients. Myocardial bridging is the most common followed by anomalous origin and proximal course and lastly coronary artery fistula. 64-Row MDCTA is an excellent promising modality and should be the first non-invasive diagnostic tool to rule out such anomalies.