Center for Coronary Artery Anomalies, Texas Heart Institute, 6624 Fannin Street, Suite 2780, Houston, TX, 77030, USA.
Curr Cardiol Rep. 2019 Jul 29;21(9):101. doi: 10.1007/s11886-019-1188-7.
Comprehensive discussion of alternative techniques in imaging coronary artery anomalies (CAAs) in different diagnostic scenarios.
At primary screening, intramural course essentially correlates with stenosis and clinical repercussion in some types of CAAs. Potential clinical aims in imaging patients with CAAs may be primary screening, severity evaluation, preoperative planning, and postoperative follow-up. Appropriate techniques are echocardiography, magnetic resonance imaging, computed tomography angiography, and intravascular ultrasound (IVUS). Rarely, IVUS may be needed in patients with potentially serious CAAs and has unique advantages and limitations. IVUS data are essential for in-depth knowledge of mechanisms of coronary dysfunction (exercise-related dynamic stenosis of variable severity) and for indicating interventional treatment. In adolescents or adults, intramural course of an anomalous coronary artery is the only important feature accompanied by stenosis of potential severity and is especially relevant in patients with a high-risk status (elite sport athletes, military recruits).
在不同诊断情况下，对冠状动脉异常（CAA）影像学检查中替代技术的全面讨论。
在初次筛查中，壁内走行与某些类型 CAA 的狭窄和临床后果密切相关。对 CAA 患者进行影像学检查的潜在临床目的可能是初次筛查、严重程度评估、术前计划和术后随访。适当的技术包括超声心动图、磁共振成像、计算机断层血管造影和血管内超声（IVUS）。在有潜在严重 CAA 的患者中，很少需要 IVUS，并且具有独特的优势和局限性。IVUS 数据对于深入了解冠状动脉功能障碍的机制（运动相关的不同严重程度的动态狭窄）和指示介入治疗非常重要。在青少年或成年人中，异常冠状动脉的壁内走行是唯一重要的特征，伴有潜在严重程度的狭窄，尤其是在高危状态的患者中（精英运动运动员、新兵）。
