Abstract
Objective: To make a pictorial presentation of the anomalous origin of left coronary artery arising from the pulmonary artery (ALCAPA) appearances in adults on MDCT angiography. Methods: A retrospective evaluation was performed between 2005 and 2011 by ECG-gated coronary MDCT angiography. Total 8 patients included (9-51 years, mean age 29 years, 7 female). Image quality was evaluated firstly. Multi planar reformations (MPRs), maximum intensity projections (MIPs) and 3D volume-rendering techniques were used to evaluate image features. In addition, right and left coronary artery orifices were measured for each case. Results: Total 8/70,000 cases diagnosed ALCAPA by MDCT exam, all image qualities were acceptable. As the diagnose key point, all left coronary artery origin were clearly described, and indirect signs such as dilated and tortuous right/left arteries and collateral vessels between them, enlarged left ventricle were also well showed, the dilated degree of both the RCA and the LCA were marked with ages, the diameter of RCA for each case were a mild wider than that of left one. Other combined signs like papillary muscle calcification, bronchial arteries from aorta to the cardiac and coronary artery degeneration change were also included by MDCT angiography findings in a single data acquisition. No combined inter cardiac malformations in our group. Conclusion: ECG-gated MDCT an-giography plays an important role as a first-line modality in assessment of ALCAPA.
Highlights
Anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) is an extremely rare but serious congenital cardiac abnormality
To make a pictorial presentation of the anomalous origin of left coronary artery arising from the pulmonary artery (ALCAPA) appearances in adults on multi-detector computed tomography (MDCT) angiography
Magnetic resonance imaging (MRI) is considered the technique of choice in patients with ALCAPA [2], because of the higher spatial resolution and faster exam time of multi-detector computed tomography (MDCT) angiography improved capabilities for assessment of both intra-cardiac anatomy and coronary arteries in a single data acquisition, this modality plays an important role in clinical practice [3]
Summary
Anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) is an extremely rare but serious congenital cardiac abnormality. ALCAPA, known as Bland-White-Garland syndrome [1], is a rare congenital defect, accounting for 0.25% - 0.50% of all congenital heart disease, 1 in 300,000 live births. Magnetic resonance imaging (MRI) is considered the technique of choice in patients with ALCAPA [2], because of the higher spatial resolution and faster exam time of multi-detector computed tomography (MDCT) angiography improved capabilities for assessment of both intra-cardiac anatomy and coronary arteries in a single data acquisition, this modality plays an important role in clinical practice [3]. The purpose of this article is to make a pictorial presentation of ALCAPA appearances in adults on MDCT angiography
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