[Coronary angiography with multislice computed tomography]

Echocardiography allows visualization of the origin of the coronary arteries and their proximal trajectory but evaluation of the middle and distal portions of these vessels is limited. Invasive coronary angiography is currently the procedure of choice to evaluate coronary anatomy. New imaging techniques have recently been developed that allow coronary structures to be visualized. One of these techniques is multislice or multidetector computed tomography (MSCT) which provides a static image of the final distribution of contrast in the vascular tree. We report a patient in whom a differential diagnosis between myopericarditis and myocardial ischemia was being considered. MSCT coronary angiography allowed the coronary tree to be visualized and anomalies in this location to be ruled out. The main limitations of MSCT coronary angiography in children are elevated cardiac frequency, making high quality images difficult to obtain, and irradiation. Although the use of MSCT coronary angiography to evaluate coronary arteries in the pediatric population currently presents considerable limitations, this procedure can be useful in selected children with suspected congenital anomalies, aneurysms or coronary fistulas who are not considered suitable candidates for conventional invasive coronary angiography.