Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction

被引:137
作者
Ropers, D
Moshage, W
Daniel, WG
Jessl, J
Gottwik, M
Achenbach, S
机构
[1] Univ Erlangen Nurnberg, Dept Internal Med 2, Erlangen, Germany
[2] Nuernberg Municipal Hosp, Dept Internal Med 8, Erlangen, Germany
关键词
D O I
10.1016/S0002-9149(00)01315-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Anomalous coronary arteries are rare conditions. However, they may cause myocardial ischemia and sudden death and their reliable identification is crucial for any imaging method that attempts coronary artery visualization. We studied the ability of contrast-enhanced electron beam tomography (EBT) to identify anomalous coronary arteries and their course. Thirty patients with previously identified coronary anomalies and 30 subjects with normal coronary anatomy were studied. By EBT, 40 to 50 axial images of the heart (3-mm slice thickness, 1 mm overlap, electrocardiagraphic trigger) were acquired in a single breathhold during continuous injection of contrast agent (160 ml, 4 ml/s). Based on the original images and 3-dimensional reconstructions, the EBT data were analyzed by 2 blinded observers as to the presence of coronary anomalies and their course. Re-suits were compared with invasive angiography. EBT correctly identified all normal controls and all patients with coronary anomalies. The anatomic course of the coronary anomalies was correctly classified in 29 of 30 patients (97%), including right-sided origin of the left main coronary artery (n = 4) or of the left circumflex coronary artery (n = 15), left-sided origin of the right coronary artery (n = 9), and 1 coronary fistula from the left circumflex coronary artery to the right atrium. Only the distal anastomosis of a second fistula from the left circumflex coronary artery to a branchial artery was not correctly identified. This study demonstrates that contrast-enhanced EBT is a reliable noninvasive technique to identify anomalous coronary arteries and their course. (C) 2001 by Excerpta Medico, Inc.
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页码:193 / 197
页数:5
相关论文
共 29 条
[1]   Value of electron-beam computed tomography for the noninvasive detection of high-grade coronary-artery stenoses and occlusions [J].
Achenbach, S ;
Moshage, W ;
Ropers, D ;
Nossen, J ;
Daniel, WG .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (27) :1964-1971
[2]  
Angelini P, 1999, Coronary artery anomalies: A comprehensive approach, P27
[3]   Cardiac MR imaging: Report of a working group sponsored by the National Heart, Lung, and Blood Institute [J].
Budinger, TF ;
Berson, A ;
McVeigh, ER ;
Pettigrew, RI ;
Pohost, GM ;
Watson, JT ;
Wickline, SA .
RADIOLOGY, 1998, 208 (03) :573-576
[4]   Intravenous three-dimensional coronary angiography using contrast enhanced electron beam computed tomography [J].
Budoff, MJ ;
Oudiz, RJ ;
Zalace, CP ;
Bakhsheshi, H ;
Goldberg, SL ;
French, WJ ;
Rami, TG ;
Brundage, BH .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 83 (06) :840-845
[5]   CLINICAL, ANGIOGRAPHIC, AND HEMODYNAMIC FINDINGS IN PATIENTS WITH ANOMALOUS ORIGIN OF CORONARY-ARTERIES [J].
CHAITMAN, BR ;
LESPERANCE, J ;
SALTIEL, J ;
BOURASSA, MG .
CIRCULATION, 1976, 53 (01) :122-131
[6]   ANOMALOUS CORONARY-ARTERIES - LOCATION, DEGREE OF ATHEROSCLEROSIS AND EFFECT ON SURVIVAL - A REPORT FROM THE CORONARY-ARTERY-SURGERY-STUDY [J].
CLICK, RL ;
HOLMES, DR ;
VLIETSTRA, RE ;
KOSINSKI, AS ;
KRONMAL, RA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 13 (03) :531-537
[7]   USEFULNESS OF MAGNETIC-RESONANCE-IMAGING FOR DIAGNOSING AN ANOMALOUS CORONARY-ARTERY COURSING BETWEEN AORTA AND PULMONARY TRUNK [J].
DOOREY, AJ ;
WILLS, JS ;
BLASETTO, J ;
GOLDENBERG, EM .
AMERICAN JOURNAL OF CARDIOLOGY, 1994, 74 (02) :198-199
[8]   THE ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN IDENTIFYING ANOMALOUS CORONARY-ARTERIES [J].
FERNANDES, F ;
ALAM, M ;
KHAJA, F ;
SMITH, S .
CIRCULATION, 1993, 88 (06) :2532-2540
[9]   ANOMALOUS ORIGIN AND COURSE OF CORONARY-ARTERIES IN ADULTS - IDENTIFICATION AND IMPROVED IMAGING UTILIZING TRANSESOPHAGEAL ECHOCARDIOGRAPHY [J].
GAITHER, NS ;
ROGAN, KM ;
STAJDUHAR, K ;
BANKS, AK ;
HULL, RW ;
WHITSITT, T ;
VERNALIS, MN .
AMERICAN HEART JOURNAL, 1991, 122 (01) :69-75
[10]  
GIANNOCCARO PJ, 1993, BRIT HEART J, V70, P70