Soon Kean H, Chaitowitz Ivan, Selvanayagam Joseph B, Kelly Anne-Maree, Zakhem Brian, Nguyen Michael, Bell Kevin W, Lim Yean L
Int J Cardiol. 2008 Oct 30;130(1):96-8. doi: 10.1016/j.ijcard.2007.06.095. Epub 2007 Aug 8.
Anomalous coronary arteries with an inter-arterial course are associated with sudden cardiac death. We reported a study comparing the accuracy of fluoroscopic coronary angiography (FCA) with that of multi-slice computed tomography (MSCT) coronary angiography in determining the proximal course of anomalous coronary arteries. Twelve patients with thirteen anomalous coronary arteries had both FCA and MSCT coronary angiography were included in this study. Twelve cardiologists individually reviewed FCAs of anomalous coronary arteries and determined the proximal course of anomalous coronary arteries as retro-aortic, inter-arterial or ante-pulmonary. Their diagnoses were compared with MSCT coronary angiography which was regarded as the reference standard in this study. On MSCT coronary angiography, there were six anomalous left circumflex arteries with a retro-aortic course, five anomalous right coronary arteries and one anomalous left anterior descending artery with inter-arterial courses, and a single anomalous left main artery with an ante-pulmonary course. The percentage of correct diagnosis made by 12 cardiologists based on FCA findings was 93/156 or 60%. None of the cardiologists was correct in determining the proximal course of all anomalous coronary arteries. The median number of anomalous coronary arteries with their proximal courses correctly identified by the cardiologists was 7.5 (range 3-12). In conclusion, FCA was limited in delineating the proximal course of anomalous coronary arteries in comparison with MSCT coronary angiography.
走行于动脉间的异常冠状动脉与心源性猝死相关。我们报告了一项研究，比较了荧光透视冠状动脉造影（FCA）与多层螺旋计算机断层扫描（MSCT）冠状动脉造影在确定异常冠状动脉近端走行方面的准确性。本研究纳入了12例患有13支异常冠状动脉的患者，这些患者均接受了FCA和MSCT冠状动脉造影检查。12位心脏病专家分别对异常冠状动脉的FCA图像进行评估，并确定异常冠状动脉的近端走行为主动脉后、动脉间或肺前。将他们的诊断结果与MSCT冠状动脉造影结果进行比较，在本研究中MSCT冠状动脉造影被视为参考标准。在MSCT冠状动脉造影中，有6支异常左旋支走行于主动脉后，5支异常右冠状动脉和1支异常左前降支走行于动脉间，还有1支异常左主干走行于肺前。12位心脏病专家根据FCA结果做出的正确诊断比例为93/156，即60%。没有一位心脏病专家能正确判断所有异常冠状动脉的近端走行。心脏病专家正确识别近端走行异常冠状动脉的中位数为7.5支（范围3 - 12支）。总之，与MSCT冠状动脉造影相比，FCA在描绘异常冠状动脉近端走行方面存在局限性。
