Mladenovic Markovic Ana, Tomic Ana, Nisevic Miodrag, Parapid Biljana, Boskovic Nikola, Vitas Marina, Jevtovic Miona, Grujicic Sandra
Centre for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia.
Medicina (Kaunas). 2025 Apr 21;61(4):765. doi: 10.3390/medicina61040765.
Coronary arteries may vary in quantity, point of origin, or course. These variations fall under the category of anatomical variants/anomalies of the coronary arteries, representing congenital abnormalities of the coronary vascular system. Generally, they are benign, asymptomatic, and identified inadvertently during coronary angiography conducted for alternative indications. However, in some cases, the anomaly's characteristics or its interaction with surrounding structures may cause hemodynamic disturbances. These disturbances can lead to turbulent blood flow, which in turn poses an increased likelihood for the development of atherosclerosis and myocardial ischemia. If symptomatic, potential manifestations include chest pain, arrhythmias, syncope, myocardial infarction, and sudden cardiac death. Given the potential for life-threatening complications in certain cases, the early and accurate diagnosis of coronary artery anomalies is of paramount importance. The most common diagnostic procedures used for the evaluation of coronary vessels are coronary angiography and multi-detector row computed tomography (MDCT) coronary angiography. MDCT angiography is a non-invasive, dependable, safe, and sensitive method for the detailed visualization of coronary anatomy. It offers high-resolution imaging that enables precise assessment of congenital coronary variations, aiding in both clinical decision-making and long-term patient management. We conducted a narrative review to analyze and integrate the body of literature on coronary artery varieties and anomalies. Our objective was to provide a comprehensive, albeit non-exhaustive, overview of essential concepts and findings related to their definition, classification, and detection with MDCT angiography. By integrating current knowledge in MDCT imaging, we seek to contribute to a better understanding of the clinical implications of coronary artery variations and their role in cardiovascular health.
冠状动脉在数量、起源点或走行方面可能存在差异。这些变异属于冠状动脉解剖变异/异常的范畴，代表着冠状血管系统的先天性异常。一般来说，它们是良性的、无症状的，在因其他指征进行冠状动脉造影时被偶然发现。然而，在某些情况下，异常的特征或其与周围结构的相互作用可能会导致血流动力学紊乱。这些紊乱会导致血流湍急，进而增加动脉粥样硬化和心肌缺血发生的可能性。如果出现症状，可能的表现包括胸痛、心律失常、晕厥、心肌梗死和心源性猝死。鉴于某些情况下可能出现危及生命的并发症，冠状动脉异常的早期准确诊断至关重要。用于评估冠状动脉的最常见诊断方法是冠状动脉造影和多排螺旋计算机断层扫描（MDCT）冠状动脉造影。MDCT血管造影是一种用于详细显示冠状动脉解剖结构的非侵入性、可靠、安全且敏感的方法。它提供高分辨率成像，能够精确评估先天性冠状动脉变异，有助于临床决策和患者的长期管理。我们进行了一项叙述性综述，以分析和整合有关冠状动脉变异和异常的文献。我们的目的是提供一个全面的（尽管并非详尽无遗的）概述，涵盖与其定义、分类以及通过MDCT血管造影进行检测相关的基本概念和研究结果。通过整合MDCT成像的现有知识，我们力求有助于更好地理解冠状动脉变异的临床意义及其在心血管健康中的作用。
