Evaluation of Efficacy of 64-Slice Multidetector Computed Tomography in Patients With Congenital Coronary Fistulas
Jonathan D. Dodd, MD, MSc, Maros Ferencik, MD, PhD,Richard R. Liberthson, MD, Koen Nieman, MD, PhD, Thomas J. Brady, MD, Udo Hoffmann, MD, MPH, Ricardo C. Cury, MD, and Suhny Abbara, MD
Objective: To evaluate the efficacy of 64-slice coronary multidetector computed tomography (MDCT) in the assessment of congenital coronary artery fistula (CCAF).
Methods: Two readers prospectively evaluated the 64-slice coronary MDCT appearances of CCAF in 10 patients (5 men and 5 women; mean age, 58.6 years; range, 19-82 years). Fistula origin, course, distal entry site, and maximal receiving chamber/vessel dimensions were determined using retrospective multisegment reconstructions at 10% increments of the cardiac cycle.
Results: Origin, course, and distal vessel entry site of CCAF were clearly outlined in all patients. The distal vessel draining site involved multiple small entry vessels in 5 patients and a single entry vessel in 5 patients. The right atrium in 3 patients and right ventricle in all patients were enlarged. Contrast opacification of the receiving chamber (contrast shunt sign) was detected in 4 patients, indicating patency and site of fistula entry.
Conclusion: Cardiac 64-slice MDCT provides excellent visualization of the origin, course, and distal vessel entry site of CCAF and the size of the receiving chamber.