Evaluation of coronary artery anomalies using 128-Slice computed tomography

Amac: Bu calismada 128 kesitli bilgisayarli tomografinin (BT) anatomik koroner arter varyasyonlarini ve anomalilerini saptamadaki etkinligi arastirildi ve elde edilen bulgular literatur verileri ile karsilastirildi. Ca­lis­ma­ pla­ni:­ Şubat 2009 Aralik 2010 tarihleri arasinda klinigimizde 128 kesitli BT ile degerlendirilen, supheli veya bilinen koroner arter hastaligi olan 83 hasta (58 erkek, 25 kadin; ort. yas 53.7±10 yil; aralik 31-80 yil) retrospektif olarak incelendi. Tum goruntuler, kardiyovaskuler radyoloji alaninda uzman bir radyolog tarafindan anatomik varyasyon ve anomali acisindan degerlendirildi. Surekli degiskenler aritmetik ortalama ± standart sapma (SS) ile ifade edilirken, kategorik degiskenler yuzde (%) ile ifade edildi. Tanimlayici istatistiksel testler ile istatistiksel analiz yapildi. Bul gu lar: Sag dominans, sol dominans ve kodominans orani sirasiyla %80.7, %8.4 ve %10.8 idi. Konus arterin %16.86 oraninda sag sinus valsalvadan ve %83.1 oraninda sag koroner arterden (sag KA) koken aldigi gozlemlendi. Sinus nod arterin (SNA) %77.1 oraninda sag KA’dan, %18.1 oraninda sirkumfleks (Cx) arterden, %2.4 oraninda sol ana koroner arterden (sol ana KA) ve %2.4 oraninda sag sinus valsalvadan koken aldigi belirlendi. Hastalarin %30.12’sinde ramus intermedius mevcuttu. Kirk sekiz hastada (%57.8) koroner arter anomalisi saptandi. Bu hastalarin %1.2’sinde sol ana KA noksanligi; %6’sinda komissural koken; %1.2’sinde koroner hipoplazi; %4.8’inde kontralateral sinus koken anomalisi ve %43.3’unde miyokard koprusu mevcuttu. So­nuc:­128 kesitli BT, koroner arter varyasyonlarinin ve anomalilerinin saptanmasinda guvenilir, ayrintili ve dogru bilgi saglayan invaziv olmayan bir yontemdir. 128 kesitli BT’nin koroner arter anomalilerinin tani ve cerrahi tedavisinde yuksek oneme sahip oldugu kanisindayiz. Anah tar soz cuk ler: Anjiyografi; anomali; bilgisayarli tomografi; koroner damarlar; tani. Background:­In this study, we aimed to investigate the efficacy of a 128-slice computed tomography (CT) device in detecting anatomical variations and anomalies of coronary arteries and to compare the results obtained with literature data. Methods: Totally, 83 patients (58 males, 25 females; mean age 53.7±10 years; range 31 to 80 years) with suspected or known coronary artery disease who underwent evaluation using the 128-slice CT in our clinic between February 2009 and December 2010 were retrospectively analyzed. All images were evaluated in terms of anatomic variation and anomaly by a radiologist with expertise in cardiovascular radiology. Continuous variables were expressed as arithmetical mean ± standard deviation (SD), while categorical variables were expressed as percent (%). Statistical analysis was performed using descriptive statistical tests. Results:­ The rate of right dominance, left dominance and co-dominance was 80.7%, 8.4% and 10.8%, respectively. It was observed that the conus artery originated from the right sinus valsalva at a rate of 16.86% and from the right coronary artery (RCA) at a rate of 83.1%. It was found that sinus node artery (SNA) originated from the RCA at a rate of 77.1%, from the circumflex (Cx) artery at a rate of 18.1%, from the left main coronary artery (LMCA) at a rate of 2.4% and from the right sinus valsalva at a rate of 2.4%. Ramus intermedius was present in 30.12% of the patients. Coronary artery anomaly was observed in 48 patients (57.8%). of them, 1.2% had absence of LMCA, 6% had commissural origin, 1.2% had coronary hypoplasia, 4.8% had anomalous of contralateral sinus origin, and 43.3% had myocardial bridging. Conclusion:­The 128-slice CT device is a non-invasive method which provides reliable, detailed and correct information for detecting variations and anomalies of coronary arteries. We believe that the 128-slice CT is of higher value in diagnosis and surgical therapy of coronary artery anomalies.