J Korean Soc Radiol.  2015 Apr;72(4):207-216. 10.3348/jksr.2015.72.4.207.

Coronary Artery Anomalies: Assessment with Electrocardiography-Gated Multidetector-Row CT at a Single Center in Korea

• Yi B
• Sun JS
• Yang HM
• Kang DK

• KMID: 1941753
• DOI: http://doi.org/10.3348/jksr.2015.72.4.207

Abstract

PURPOSE
To determine the prevalence of coronary anomalies using coronary computed tomography angiography (CCTA) and to evaluate the relationship between coronary artery anomalies and chest pain.
MATERIALS AND METHODS
A total of 12676 patients underwent CCTA scans at our institution between December 2006 and April 2013 using a 64-slice CT and a 128-slice dual-source CT. We determined the prevalence of coronary artery anomalies according to the classification system proposed by Greenberg. The presence or absence of chest pain with each coronary artery anomaly was also evaluated.
RESULTS
Coronary anomalies were found in 176 patients (1.39%) at our institute. Anomalies of origination, course, and termination were detected in 118 (0.93%), 28 (0.22%), and 30 (0.24%) patients, respectively. After the exclusion of 32 patients with combined heart disease, typical (n = 16; 11.1%) or atypical (n = 28; 19.4%) chest pain was present in 44 (30.6%) of the 144 patients at the time of diagnosis.
CONCLUSION
The prevalence of coronary artery anomalies was 1.39% at our hospital. After the exclusion of patients with combined heart disease, 11.1% had typical chest pain at the time of diagnosis.

MeSH Terms

Angiography
Chest Pain
Classification
Coronary Vessels*
Diagnosis
Heart Diseases
Humans
Korea
Prevalence

Figure

• 

  Fig. 1 63 years old male patient with atypical angina. A, B. Volume rendering technique and three-dimensional maximum intensity projection images show aplasia of right coronary artery (RCA) and collateral vessel from left circumflex artery (arrow). C. Coronary angiography shows left dominant coronary artery with RCA aplasia.

• 

  Fig. 2 82 years old male patient with atypical angina. A, B. Volume rendering technique and coronary angiography show tortuous vessels arising from the proximal left anterior descending (black arrow) and right coronary sinus (white arrow) and draining into pulmonary trunk. Multiple tortuous vascular structures passes anterior to the pulmonary artery and forms a network (*) before it enters the pulmonary trunk. C. Axial CT image shows the entry site (arrowhead) into pulmonary trunk.

• 

  Fig. 3 57 years old female patient with typical angina. A. Volume rendering technique shows anomalous right coronary artery (RCA) ostium from the left coronary sinus. B. Oblique sagittal multiplanar reformation image shows RCA (arrow) travels between aorta (Ao) and pulmonary artery (*).

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