Coronary artery anomalies: Assessment with free-breathing three-dimensional coronary MR angiography

Nicholas H. Bunce, Christine H. Lorenz, Jennifer Keegan, John Lesser, Eliana M. Reyes, David N. Firmin, Dudley J. Pennell

Research output: Contribution to journalArticle

Abstract

PURPOSE: To evaluate a simplified protocol by using free-breathing three-dimensional (3D) coronary magnetic resonance (MR) angiography to determine the anatomy of anomalous coronary arteries, in particular the relationship of the vessels to the aortic root. MATERIALS AND METHODS: Twenty-six patients (18 men, eight women; mean age, 50 years; age range, 18-77 years) who had a history of chest pain, palpitations, or syncope and who were suspected of having coronary artery anomalies were examined with free-breathing MR angiography. Multiple 3D volume slabs were acquired at the level of the sinuses of Valsalva by using diaphragmatic navigators for respiratory artifact suppression. The proximal anatomy of the coronary arteries was determined. RESULTS: Six anomalous circumflex arteries originated from the right sinus of Valsalva and passed behind the aortic root. Six right coronary arteries arose from the left sinus of Valsalva and coursed between the aortic root and the right ventricular outflow tract (RVOT). Nine left coronary arteries arose from the right sinus of Valsalva; seven of nine coursed between the aortic root and the RVOT. Five patients had minor anomalies. Overall, in eight patients with anomalous arteries that coursed between the aortic root and the RVOT, conventional coronary angiography could not be used confidently to identify the proximal course. CONCLUSION: Free-breathing 3D coronary MR angiography can be used to identify the proximal anatomy of anomalous coronary arteries.

Original languageEnglish (US)
Pages (from-to)201-208
Number of pages8
JournalRadiology
Volume227
Issue number1
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

Fingerprint

Magnetic Resonance Angiography
Coronary Angiography
Sinus of Valsalva
Coronary Vessels
Respiration
Anatomy
Arteries
Syncope
Chest Pain
Artifacts

Keywords

  • Coronary angiography, comparative studies
  • Coronary vessels, abnormalities
  • Magnetic resonance (MR), vascular studies

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Bunce, N. H., Lorenz, C. H., Keegan, J., Lesser, J., Reyes, E. M., Firmin, D. N., & Pennell, D. J. (2003). Coronary artery anomalies: Assessment with free-breathing three-dimensional coronary MR angiography. Radiology, 227(1), 201-208. https://doi.org/10.1148/radiol.2271020316

Coronary artery anomalies : Assessment with free-breathing three-dimensional coronary MR angiography. / Bunce, Nicholas H.; Lorenz, Christine H.; Keegan, Jennifer; Lesser, John; Reyes, Eliana M.; Firmin, David N.; Pennell, Dudley J.

In: Radiology, Vol. 227, No. 1, 01.04.2003, p. 201-208.

Research output: Contribution to journalArticle

Bunce, NH, Lorenz, CH, Keegan, J, Lesser, J, Reyes, EM, Firmin, DN & Pennell, DJ 2003, 'Coronary artery anomalies: Assessment with free-breathing three-dimensional coronary MR angiography', Radiology, vol. 227, no. 1, pp. 201-208. https://doi.org/10.1148/radiol.2271020316
Bunce, Nicholas H. ; Lorenz, Christine H. ; Keegan, Jennifer ; Lesser, John ; Reyes, Eliana M. ; Firmin, David N. ; Pennell, Dudley J. / Coronary artery anomalies : Assessment with free-breathing three-dimensional coronary MR angiography. In: Radiology. 2003 ; Vol. 227, No. 1. pp. 201-208.
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AB - PURPOSE: To evaluate a simplified protocol by using free-breathing three-dimensional (3D) coronary magnetic resonance (MR) angiography to determine the anatomy of anomalous coronary arteries, in particular the relationship of the vessels to the aortic root. MATERIALS AND METHODS: Twenty-six patients (18 men, eight women; mean age, 50 years; age range, 18-77 years) who had a history of chest pain, palpitations, or syncope and who were suspected of having coronary artery anomalies were examined with free-breathing MR angiography. Multiple 3D volume slabs were acquired at the level of the sinuses of Valsalva by using diaphragmatic navigators for respiratory artifact suppression. The proximal anatomy of the coronary arteries was determined. RESULTS: Six anomalous circumflex arteries originated from the right sinus of Valsalva and passed behind the aortic root. Six right coronary arteries arose from the left sinus of Valsalva and coursed between the aortic root and the right ventricular outflow tract (RVOT). Nine left coronary arteries arose from the right sinus of Valsalva; seven of nine coursed between the aortic root and the RVOT. Five patients had minor anomalies. Overall, in eight patients with anomalous arteries that coursed between the aortic root and the RVOT, conventional coronary angiography could not be used confidently to identify the proximal course. CONCLUSION: Free-breathing 3D coronary MR angiography can be used to identify the proximal anatomy of anomalous coronary arteries.

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