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Updated: Jun 12, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Sixty-four-multi-detector computed tomography diagnosis of coronary artery anomalies in 66 patients
Shan Yang1, Meng-Su Zeng, Zhi-Yong Zhang
1Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Insights
64-detector computed tomography (MDCT) effectively identifies coronary artery anomalies, which can cause serious cardiac events. This non-invasive imaging is recommended for suspected cases, offering detailed anatomical assessment.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery abnormalities, though rare, can lead to myocardial infarction or sudden death.
- Multi-detector computed tomography (MDCT) is a valuable non-invasive tool for detecting these anomalies.
- This study reviewed the clinical significance and MDCT appearance of coronary artery anomalies.
Purpose of the Study:
- To evaluate the appearance of coronary artery anomalies using 64-MDCT.
- To determine the incidence of coronary artery anomalies in symptomatic patients.
- To discuss the clinical importance of detected anomalies.
Main Methods:
- 64-MDCT was performed on 6014 patients over 12 months.
- 66 patients with diagnosed coronary artery anomalies were analyzed.
- CT images were reviewed by radiologists and a cardiologist; specific anomalies were excluded.
Main Results:
- The incidence of coronary artery anomalies was 1.097%.
- Seven types of anomalies were identified, with high takeoff, anomalous origin, and fistula being most common.
- Coronary artery computed tomography angiography (CTA) accurately depicted origin, course, and spatial relationships, surpassing conventional angiography in some cases.
Conclusions:
- 64-MDCT, particularly with volume rendering technique (VRT), is effective for assessing complex coronary artery variations.
- MDCT provides superior diagnostic information compared to conventional angiography in certain cases.
- MDCT should be considered the primary imaging modality for suspected anomalous coronary arteries.
Background:
The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography (MDCT) is a non-invasive test that is highly suitable for detecting these anomalies. The study aimed to review the 64-MDCT appearance of the coronary artery anomalies in 66 patients and to discuss the clinical importance of these anomalies.
Methods:
In 6014 consecutive patients examined over 12 months by 64-MDCT for the study of coronary artery disease, 66 were diagnosed for coronary artery anomalies. All patients were symptomatic for one or more of the following diseases: chest pain, dyspnoea, palpitations, arrhythmia and myocardial infarction. Nine patients had undergone a coronary angiography. All the CT images were evaluated by two radiologists and one cardiologist. The right coronary artery (RCA) and the conus branch arising separately, myocardial bridging and duplication of arteries were not analysed in our study.
Results:
The incidence of coronary artery anomalies found in our study group was 1.097%. In the selected patients, seven different types of coronary anomalies were found by 64-MDCT examination. The high takeoff, origin of the coronary artery from the opposite or noncoronary sinus with an anomalous course, and coronary artery fistula were the three common forms of anomalies (n = 16, 18 and 16, respectively). Compared with the results of the coronary angiography, the number of the drainage sites of two coronary artery fistula was less in MDCT images (3 small sites in total). In all cases, coronary artery computed tomography angiography (CTA) technique was able to recognize the origin of the coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures. Conventional coronary angiography in two cases, however, was unable to provide sufficient information for correct and complete diagnosis.
Conclusions:
In conclusion, the study showed that 64-MDCT, especially the volume rendering technique (VRT), may be useful for the assessment of complex variations, even if the conventional angiography may not be sufficient. It may be considered as the first-choice imaging modality when an anomalous coronary artery is suspected.
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