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Updated: Sep 27, 2026
Three-Dimensional Printing of a Complex Aortic Anomaly
Published on: November 1, 2018
Coronary artery anomalies: assessment with free-breathing three-dimensional coronary MR angiography
Nicholas H Bunce1, Christine H Lorenz, Jennifer Keegan
1CMR Unit, Royal Brompton Hospital, Sydney St, London SW3 6NP, England.
Insights
Free-breathing three-dimensional (3D) coronary magnetic resonance (MR) angiography accurately identifies anomalous coronary arteries. This simplified protocol effectively visualizes vessel anatomy, particularly their relationship to the aortic root.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Radiology
Background:
- Coronary artery anomalies can lead to serious cardiac events.
- Accurate anatomical assessment is crucial for diagnosis and management.
- Conventional angiography may have limitations in visualizing complex anomalies.
Purpose of the Study:
- To evaluate a simplified free-breathing 3D coronary MR angiography protocol.
- To determine the proximal anatomy of anomalous coronary arteries.
- To assess the relationship of anomalous vessels to the aortic root.
Main Methods:
- Twenty-six patients with suspected coronary anomalies underwent free-breathing 3D MR angiography.
- Diaphragmatic navigators were used for respiratory artifact suppression.
- Multiple 3D volume slabs were acquired to visualize coronary anatomy.
Main Results:
- The protocol successfully identified various coronary artery anomalies, including anomalous circumflex and coronary arteries.
- Specific anomalous courses relative to the aortic root and RVOT were detailed.
- MR angiography provided clearer visualization than conventional angiography in eight patients.
Conclusions:
- Free-breathing 3D coronary MR angiography is effective for identifying anomalous coronary arteries.
- This technique offers valuable insights into coronary anatomy, especially concerning the aortic root.
- The simplified protocol enhances diagnostic capabilities for coronary artery anomalies.
Purpose:
To evaluate a simplified protocol by using free-breathing three-dimensional (3D) coronary magnetic resonance (MR) angiography to determine the anatomy of anomalous coronary arteries, in particular the relationship of the vessels to the aortic root.
Materials And Methods:
Twenty-six patients (18 men, eight women; mean age, 50 years; age range, 18-77 years) who had a history of chest pain, palpitations, or syncope and who were suspected of having coronary artery anomalies were examined with free-breathing MR angiography. Multiple 3D volume slabs were acquired at the level of the sinuses of Valsalva by using diaphragmatic navigators for respiratory artifact suppression. The proximal anatomy of the coronary arteries was determined.
Results:
Six anomalous circumflex arteries originated from the right sinus of Valsalva and passed behind the aortic root. Six right coronary arteries arose from the left sinus of Valsalva and coursed between the aortic root and the right ventricular outflow tract (RVOT). Nine left coronary arteries arose from the right sinus of Valsalva; seven of nine coursed between the aortic root and the RVOT. Five patients had minor anomalies. Overall, in eight patients with anomalous arteries that coursed between the aortic root and the RVOT, conventional coronary angiography could not be used confidently to identify the proximal course.
Conclusion:
Free-breathing 3D coronary MR angiography can be used to identify the proximal anatomy of anomalous coronary arteries.
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