Korean J Radiol.  2012 Oct;13(5):572-578. 10.3348/kjr.2012.13.5.572.

Anatomy of the Sinoatrial Nodal Branch in Korean Population: Imaging with MDCT

Affiliations
  • 1Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. whal.lee@gmail.com

Abstract


OBJECTIVE
To evaluate, on a retrospective basis, the anatomic characteristics of the arterial supply to the sinoatrial node (SAN) in the Korean population using an ECG-gated multi-detector CT (MDCT).
MATERIALS AND METHODS
The electrocardiographic-gated MDCTs of 500 patients (258 men and 242 women; age range, 17-83 years; mean age, 58.6 +/- 12.04 years) were analyzed retrospectively. In each case, the SAN artery (arteries) was named according to a special nomenclature with regard to origin, course, and termination.
RESULTS
A total of 516 SAN arteries were visualized in 496 patients. The SAN was supplied by a single artery in 476 (96.4%) cases and by 2 arteries in 18 (3.6%) cases. The SAN originated from the right coronary artery in 265 (53.4%) cases and from the left circumflex in 213 (43%) cases.
CONCLUSION
This study can provide basic data on variations of the SAN artery in the Korean population.

Keyword

Sinoatrial node; Sinoatrial nodal artery; SA node; ECG-gated MDCT; Korean population

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
*Cardiac-Gated Imaging Techniques
Coronary Vessel Anomalies/*radiography
Female
Humans
Male
Middle Aged
Republic of Korea
Retrospective Studies
Sinoatrial Node/*radiography
Tomography, X-Ray Computed/*methods

Figure

  • Fig. 1 R1 subtype SAN artery (white arrow) arising from RCA is seen in axial MIP view. AAo = ascending aorta, LA = left arium, SVC = superior vena cava, SAN = sinoatrial node, RCA = right coronary artery, R1 = medial to the right auricle, MIP = maximum ittensity projection

  • Fig. 2 L1 subtype SAN artery (black arrow) arising from LCX is seen in axial MIP view. AAo = ascending aorta, LA = left arium, SVC = superior vena cava, SAN = sinoatrial node, MIP = maximum ittensity projection, LCX = left circumflex

  • Fig. 3 MIP images show SAN artery subtypes according to course of terminal segment around SVC. A. Precaval (white arrow). B. Retrocaval (black arrow). C. Pericaval (black arrow). AAo = ascending aorta, LA = left arium, MIP = maximum ittensity projection, SAN = sinoatrial node, SVC = superior vena cava

  • Fig. 4 R1m subtype SAN artery (white arrows) arising from middle segment of RCA (black arrow). AAo = ascending aorta, LA = left arium, SAN = sinoatrial node, SVC = superior vena cava, RCA = right coronary artery, R1m = originated from middle segment of right coronary artery and run medial to right auricle

  • Fig. 5 S-shaped SAN artery (black and white arrows) arising from LCX and running between left superior pulmonary vein and left atrial auricular is seen in MIP images (A, B). AAo = ascending aorta, SAN = sinoatrial node, SVC = superior vena cava, LAA = left atrial appendage, LCX = left circumflex, LSPV = left superior pulmonary vein, MIP = maximum ittensity projection


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