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Virtual endoluminal aortic root views determined at coronary CT angiography - an important tool for improving

Vijetha V Maller1,2, Harris L Cohen3,4, Umar Boston5,6

  • 1Department of Radiology, Le Bonheur Children's Hospital, 848 Adams Ave., Radiology G216, Memphis, TN, 38103, USA. vmaller1@uthsc.edu.

Pediatric Radiology
|September 5, 2020
PubMed

Insights

Anomalous coronary artery origins, though rare, pose significant risks. Electrocardiographically-gated multi-detector CT with virtual endoluminal imaging enhances diagnosis of these dangerous coronary artery anomalies.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Anomalous origin of the coronary arteries is uncommon but clinically significant, potentially causing sudden cardiac death and abnormal cardiac hemodynamics.
  • Electrocardiographically (ECG)-gated multi-detector CT (MDCT) has improved the diagnostic accuracy for coronary artery anomalies.

Purpose of the Study:

  • To review the utility of virtual endoluminal imaging via MDCT in assessing interarterial coronary artery anomalies.
  • To evaluate the preoperative diagnosis and surgical correlation of these anomalies.

Main Methods:

  • Review of 19 cases diagnosed with interarterial coronary artery anomalies.
  • Utilized ECG-gated MDCT with advanced image processing for virtual endoluminal views of the aortic root.
  • Assessed intramural course, length, and relationship to the intercoronary commissure.

Main Results:

  • Successfully diagnosed 19 cases of interarterial coronary artery anomalies preoperatively.
  • 17 cases involved an interarterial course with an intramural segment; 2 had a purely interarterial course.
  • Virtual endoluminal imaging provided improved assessment of the coronary artery's intramural course.

Conclusions:

  • Virtual endoluminal imaging with MDCT is valuable for diagnosing coronary artery anomalies.
  • This technique aids in assessing the surgical importance of the intramural course of anomalous coronary arteries.
  • Preoperative diagnosis using this method correlates well with surgical findings.

Keywords:
Anomalous coronary arteryAortic rootChildrenComputed tomographic angiographyCoronary arteriesHeartInterarterial courseIntramural segmentThree-dimensionalVirtual endoluminal views

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