Document Detail


Anomalous origin of the coronary arteries in children: diagnostic role of three-dimensional coronary MR angiography.
MedLine Citation:
PMID:  20813295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
When the anomalous origin of coronary arteries (AOCA) is suspected in children (especially athletes), due to signs and symptoms of myocardial ischemia or on the basis of echocardiographic assessment, three-dimensional coronary magnetic resonance angiography (3D-CMRA) can be proposed for the fine morphological evaluation of coronary branches anatomy and course. We tested the diagnostic potential of CMRA angiography in a prospective study on AOCA in young patients. Between July 2005 and June 2008, 15 patients aged 6-29 years (mean age, 13.5 years+/-5.6 S.D.; median, 14) with clinical and echocardiographic suspicion of AOCA underwent CMRA (1.5 T), 3D whole-heart, free-breathing technique, without the use of contrast medium and beta-blockers, with a mean examination time of 30 min. We acquired a second scan of all patients to ameliorate the quality of the acquisition and to improve our experience. AOCA was confirmed by 3D-CMRA in 8 out of 15 cases (53%) and three different anatomical variants were demonstrated, that is, ectopic origin of the left circumflex artery arising from the right coronary artery with retro-aortic course in four cases, single coronary artery arising from the right sinus of Valsalva with interarterial course in one case, ectopic right coronary artery arising from the left sinus of Valsalva with interarterial course in one case; in two patients without anomalies of origin of the coronary arteries, elongated LMCA with angulation of the proximal segment of the left circumflex artery was present. When AOCA is suspected particularly in children (especially athletes), CMRA without the use of contrast medium is an effective diagnostic technique, which is useful to clarify the spatial position of the anomalous course of the main coronary branches in order to suggest the most convenient management of the disease. CMRA does not need contrast medium, needles, and beta-blockers; is repeatable in the same examination without the exposure to X-rays; allows a parent to stay near the child; and needs low collaboration in low-stress conditions.
Authors:
Alberto Clemente; Mario Del Borrello; Pietro Greco; Paolo Mannella; Franco Di Gregorio; Silvia Romano; Aldo Morra
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Clinical imaging     Volume:  34     ISSN:  1873-4499     ISO Abbreviation:  Clin Imaging     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-09-03     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911831     Medline TA:  Clin Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-43     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of Ferrara, Corso Giovecca, Ferrara (Fe), Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Coronary Vessel Anomalies / complications,  diagnosis*
Coronary Vessels / pathology
Humans
Image Processing, Computer-Assisted / methods
Imaging, Three-Dimensional / methods*
Magnetic Resonance Angiography / methods*
Myocardial Ischemia / etiology
Observer Variation
Prospective Studies
Reproducibility of Results
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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