BACKGROUND This registry compared the findings of different modalities in patients showing Coronary Artery Anomalies (CAA) to determine the usefulness of Multi-detector Computed Tomography Angiography (MDCTA). METHODS A retrospective review of patients who underwent coronary imaging was performed. Patients diagnosed for CAA were included. Their results on imaging modalities were compared. RESULTS CAAs were detected in 257 out of 17,245 patients (1.49%). Fifty-five (0.319%) had separate origins of left anterior descending and circumflex arteries from left-sinus. ICA and MDCTA were equivalent (p=1) for its detection. Thirty-four patients had abnormal high origin near same sinus. ICA had lower sensitivity (52.9%) than MDCTA (100%) (p=0.0001) for its detection. Both modalities had 100% specificity. Anomalous coronary arteries from opposite sinus (ACAOS) were found in 88 patients (0.51%). ICA has 95.9% sensitivity, 100% specificity for diagnosis and 91.8% sensitivity for course-delineation. MDCTA has 100% sensitivity and specificity. For ACAOS, diagnostic accuracies of both were equivalent (p=0.49). Course-delineation was better with MDCTA than with ICA (p=0.05). Radiation-exposure with ICA (7.3±2mSv) was lower than that with MDCTA (14.5±3mSv) (p<0.0001). Radiation-exposure for ACAOS was more than that for other anomalies with ICA (p<0.001), but not with MDCTA (p=0.18). Radiation-exposure with ICA correlated with CAAscore (r=0.3), especially for origin and course anomalies (r=0.6). With MDCTA, that did not correlate with CAA-score (r=-0.019). Contrast-expenditure during ICA (65.55±19.9ml) and MDCTA (63.15±15.6ml) were equivalent (p=0.52). Contrast-expenditure during ICA in adults correlated with CAA-score (r=0.42), in contrast to MDCTA (r=-0.04). CONCLUSION MDCTA is a good modality for detection and course delineation of CAAs. Radiation and contrast-exposure with MDCTA does not correlate with complexity of CAA.
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