Clinical application of dual-source CT in the diagnosis of ALCAPA

Abstract

Objective To explore the clinical usefulness of anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) by dual-source CT (DSCT) angiography. Methods A total of 10 patients (mean age 5.1±5.0 yrs, age range 0.2-15 yrs| male 5) with ALCAPA who underwent DSCT angiography and echocardiography were retrospectively included.Surgery was performed in 7 patients, and conventional cardiac angiography (CCA) in 4 patients.The subjective image quality was evaluated on a four-point scale by two radiologists.Radiation dose values were calculated. Results ALCAPA in all patients were accurately displayed with DSCT with the accuracy of 100%.The left coronary arteries originate from the inferior-left wall of the pulmonary artery in 1 patients, from left lateral wall in 3 patients, from right lateral wall in 4 patients and posterior wall in 2 patients, respectively.In all cases, the origins of the right coronary artery were normal and originated from the right sinus of Valsalva of aorta,the right coronary artery was turtuous and dilated in 5 patients.All DSCT images were diagnosable.The average subjective image quality score was 2-4 (3.2±0.8).Two radiologists made good agreement (k=0.79).The ED was (0.56±0.28) mSv.Seven cases were diagnosed correctly by echocardiography while 3 cases was misdiagnosed as dilated cardiomyopathy, left coronary artery-pulmonary artery fistula and endocardial fibroelastosis, respectively. Conclusion Low-dose DSCT angiography provides high diagnostic accuracy for the assessment of ALCAPA. Key words: Coronaryarterydisease; Tomography,X-raycomputed; Echocardiography