Department of Radiology, Ankara Training and Research Hospital, Turkey.
Diagn Interv Radiol. 2009 Dec;15(4):275-83. doi: 10.4261/1305-3825.DIR.2550-09.1. Epub 2009 Dec 2.
To retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery anatomic variants and anomalies and determine their incidence in 700 patients.
CT data of 700 patients who underwent 64-slice CT angiography (CTA) because of known or suspected coronary artery disease were retrospectively reviewed by two radiologists experienced in cardiovascular radiology. In each study, anatomic variants and anomalies were investigated.
The coronary artery system was right dominant in 76%, left dominant in 9.1% and co-dominant in 14.8% of the cases. Ramus intermedius was present in 31%. Conus artery with a separate ostium in the right sinus Valsalva was observed in 22%, and in 0.2% two conus arteries originating with separate ostia were visualized. The sinus node artery (SNA) originated from the right coronary artery (RCA) in 79%, from the circumflex artery (Cx) in 20%, and from the left main coronary artery (LMCA) in 0.4%. In 0.4% of the cases SNA originating from the right sinus Valsalva with a separate ostium was seen. LMCA was absent in 0.4%. Cx was absent in 0.1%, and diagonals were absent in 0.1%. High takeoff of LMCA and RCA were observed in 0.7% and 0.1%, respectively. Myocardial bridging was observed in 37%. Anomalous origin of the coronary artery from the opposite sinus was observed in 1% of the cases.
Complex anatomy of the coronary artery system can accurately be depicted by 64-slice CTA. This modality is useful in detecting coronary artery variants and anomalies and is a valid alternative to conventional coronary angiography in their diagnosis.
回顾 64 层 CT（CT）对冠状动脉解剖变异和异常的表现，并确定其在 700 例患者中的发生率。
对 700 例行 64 层 CT 血管造影（CTA）检查的患者的 CT 数据进行回顾性分析，这些患者均因已知或疑似冠状动脉疾病而进行了检查。在每一项研究中，均对解剖变异和异常进行了研究。
在 700 例患者中，右优势型占 76%，左优势型占 9.1%，均衡型占 14.8%。中间支动脉（ramus intermedius）的发生率为 31%。观察到 22%的圆锥动脉（conus artery）有一个单独的开口在右窦房结，0.2%的患者可见两个圆锥动脉有单独的开口。窦房结动脉（sinus node artery，SNA）起源于右冠状动脉（right coronary artery，RCA）的占 79%，起源于回旋支（circumflex artery，Cx）的占 20%，起源于左主干冠状动脉（left main coronary artery，LMCA）的占 0.4%。在 0.4%的患者中，SNA 起源于右窦房结并有一个单独的开口。0.4%的患者没有 LMCA。0.1%的患者没有回旋支，0.1%的患者没有对角支。LMCA 和 RCA 的高位起自分别为 0.7%和 0.1%。37%的患者存在心肌桥。1%的患者存在冠状动脉的起源异常。
64 层 CTA 可以准确地显示冠状动脉系统的复杂解剖结构。这种方法有助于发现冠状动脉的变异和异常，并且是传统冠状动脉造影在诊断中的有效替代方法。
