INTRODUCTIONProficiency in the anatomy of coronary arteries and their variations is important for proper interpretation of coronary angiographies. The left coronary artery (LCA) commonly originates at the level of the left posterior aortic sinus and normally bifurcates into the anterior interventricular artery and circumflex artery. This study aimed to determine the variations in the LCA and its branches.

METHODSThe study was conducted on 30 heart specimens. We observed the origin, length and branching pattern of the LCA and its coronary dominance.

RESULTSWe found a short main LCA trunk in three specimens and a long main LCA trunk in one specimen. In two specimens, the division of the LCA led to three branches. With regard to 'dominance', one specimen showed left dominance while another showed codominance.

CONCLUSIONVariations of the LCA are clinically relevant, especially when a perioperative coronary perfusion or coronary arteriography is performed.

Aged ; Aged, 80 and over ; Anatomy ; methods ; Cadaver ; Coronary Angiography ; methods ; Coronary Vessels ; anatomy & histology ; Heart ; anatomy & histology ; Humans ; Middle Aged ; Models, Anatomic

OBJECTIVETo obtain the coronary artery and coronary sinus (CS) and its tributaries imaging with multislice computed tomography (MSCT), measure the distance between coronary artery and CS and its tributaries and analyze their spatial relationships.

METHODSThe MSCT scans of 117 patients (67 men, 50 women, age 56 +/- 10 years) were obtained, 3D image reconstructed and the vessels courses evaluated. The concomitant distances and spatial relationships of the vessels were determined.

RESULTSRight coronary artery domination was found in 107 cases (91.4%), left coronary artery domination in 7 cases (6.0%), and co-domination in 3 cases (2.6%). Left circumflex artery (LCX) was concomitant with CS or the great cardiac vein (GCV) in 81 cases (69.2%), intersected with left posterior vein in 62 cases (53.0%) and with middle cardiac vein (MCV) in 5 cases (4.3%), respectively. The dominant coronary artery branched out into the posterior descending artery (PDA) and the left posterior artery (LPA) in 112 cases (95.7%). PDA was concomitant with MCV in 93 cases (79.5%) and intersected with MCV in 44 cases (37.6%). LPA was intersected with MCV in 106 cases (90.6%), and concomitant with CS in 50 cases (42.7%).

CONCLUSIONSMSCT is a reliable tool to visualize the relationship between coronary artery and CS and its tributaries. Owing to the multiple possibilities inherent to this technique, MSCT has broad potential for more clinical use.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Sinus ; anatomy & histology ; diagnostic imaging ; Coronary Vessels ; anatomy & histology ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed

UNLABELLEDThis study was conducted to reconstruct three-dimensional medical images based on web and to achieve highly realistic display. Using the volume rendering techniques to reconstruct and display three-dimensional images in Java Applet program and utilizing signed Applets for solving security problem, We got two-dimensional images of human organs from ultrafast CT as sources and reconstructed the organs configuration of heart, coronary artery, head, cervical vertebrae, and pelvis. This reconstruction can be run in Web browser on different kinds of computers and for virtual surgical planning.

CONCLUSIONS1. Three-dimensional medical image reconstruction in Web browser implemented by Java Applet is feasible, which will prompt clinical use of three-dimensional images. 2. The solid conformation of human organs, especially the anatomic structure of the coronary artery, can be displayed by using three-dimensional reconstruction techniques, which may offer more information to clinics.

Coronary Vessels ; anatomy & histology ; Diagnostic Imaging ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Internet ; Software

OBJECTIVETo explore the value of phase ordering with automatic window selection(PAWS)and simultaneous multiple volume(SMV)algorithm double respiratory navigator-gated two-dimensional(2DNAV)dual inversion recovery(DIR)fast spin echo(FSE)high-resolution black-blood coronary artery wall magnetic resonance imaging(MRI)and evaluate its advantages and limitations.

METHODSPAWS and SMV 2DNAV DIR FSE high-resolution black-blood MRI was performed in 21 healthy volunteers. The images were evaluated qualitatively by using four grades(grade 0can not evaluate;grade 1bad;grade 2good;grade 3perfect). Images defined as grade 0 and grade 1 were excluded and those defined as grade 2 and 3 were evaluated further. Thickness of proximal(or middle)segment of right coronary artery(RCA)and left anterior descending branch(LAD)were measured. The difference of wall thickness was analyzed by using two-tailed independent sample t-test. P values of less than 0.05 were considered statistically significant.

RESULTSAmong the 38 slice images,31 slices(RCA13 slices,LAD18 slices;grade 214 slices,grade 317 slices)were obtained for further evaluation. The mean thickness of RCA and LAD was(0.94±0.16)and(0.89±0.15)mm,respectively,and the difference was not significant(t=-0.790,P>0.05).

CONCLUSIONPAWS and SMV algorithm 2DNAV DIR FSE high-resolution black-blood MRI has certain clinical value for coronary artery wall imaging.

Adult ; Coronary Vessels ; anatomy & histology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To measure the inferior epigastric artery(IEA),coronary artery and arterial bridge to supply the anatomic and hemodynamic data of IEA in coronary artery bypass grafting for clinicians. METHODS: Anatomic method was adopted to measure the length of IEA, arterial bridge, the outer diameter of IEA and coronary arteries. Colour doppler ultrasound instrument was adopted to measure the caliber and the blood flow rate of IEA and coronary artery. RESULTS: In the anatomic method, the length of IEA was (13.00+/-2.58)cm and the caliber of original IEA was (2.95+/-0.21)mm, the caliber of IEA intersecting with abdomen rectus was (2.51+/-0.32)mm, and (1.60+/-0.26)mm at 1.0 cm below the umbilicus. In color doppler ultrasound method, the caliber of original IEA was (2.98+/-0.37)mm, and at 5 cm from the original spot was (2.60+/-0.27)mm. The blood flow rate was (57.00+/-6.78)cm/s. The main stem caliber of the left coronary artery was (4.90+/-0.76)mm, and that of the right coronary artery was (3.58+/-0.63)mm; the blood flow rate was (48.50+/-7.72)cm/s. The length of the arterial bridge was (10.95+/-1.35) approximately (15.30+/-2.82)cm. CONCLUSION IEA can bridge the aorta and the coronary artery branches including the left anterior descending branch, the left circumflex branch and the right main coronary artery in free grafting. Its caliber and blood flow rate can match with those of the coronary artery. Before the operation of applying color doppler ultrasound instrument, the safety of IEA in the coronary artery bypass grafting can be evaluated to provide a new safe method in clinical follow-up.
Cadaver ; Coronary Artery Bypass ; methods ; Coronary Vessels ; anatomy & histology ; Epigastric Arteries ; anatomy & histology ; transplantation ; Female ; Humans ; Male ; Vascular Surgical Procedures ; methods

OBJECTIVETo observe the coronary vessel lumen diameter and bifurcation angle in subjects with normal CT coronary angiography (CTCA) imaging.

METHODS64-row CT coronary angiography imaging from 526 adult people with excellent image quality and normal vascular image were analyzed in this study. The lumen diameter from the origin to distal with 2 mm lumen of left main coronary artery (LM), anterior descending branch (LAD), left circumflex branch (LCX) and right coronary artery (RCA) was measured at 1 cm interval in CPR image. The vascular tapered ratio was calculated. The bifurcation angle in the diagonal branch, obtuse marginal branch, posterior descending branch, acute marginal branch as well as the origin diameter was also measured in VR image.

RESULTSThe LAD average length was 13 cm and lumen diameter was 3.92 mm at origin and 2.10 mm at distal. The average decremented ratio of LAD was 7.7% (male 7.0%, female 8.4%). The maximal decremented ratio 8.0% - 10.0% occurred at 3 - 5 cm apart from the origin of LAD. The LCX average length was 13 cm and lumen diameter was 3.57 mm at origin and 2.10 mm at distal. The average decremented ratio of LCX was 9.7% (male 9.6%, female 9.7%). Lumen decremented ratio was less than 3.0% between origin and proximal 3 cm and 8.3% - 10.7% in the rest portion of the LCX. The RCA average length was 18 cm and lumen diameter was 3.97 mm at origin and 2.15 mm at distal. The average decremented ratio of RCA was 5.1% (male 4.9%, female 5.3%). The decremented ratio of RCR was less than 4.0% between origin and proximal 10 cm and 6.1% - 15.2% in the rest portion. The bifurcation angle was 50, 55, 66 and 76 degree for LAD with diagonal branch, LCX with obtuse marginal branch, RCA with posterior descending branch and RCA with obtuse marginal branch respectively.

CONCLUSIONCoronary artery length, lumen diameter and decremented ratio as well as bifurcation angel could be identified in 64 row CTCA image in vivo. This information could help us to understand the in vivo coronary artery anatomy.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Stenosis ; diagnostic imaging ; Coronary Vessels ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed

INTRODUCTIONThe incidence of coronary artery anomalies (CAAs) varies from 0.2% to 8.4%. Knowledge of such anatomical variations is important as coronary procedures are regularly performed these days. We aimed to find the coronary dominance pattern, intermediate artery (IMA) frequency and CAA incidence in our clinic, and compare them to those in the literature.

METHODSThe medical reports of 5,548 patients who had undergone coronary angiography (CAG) between 2005 and 2009 were retrospectively investigated. Dominance pattern and presence of IMA and CAA were recorded. CAAs were described using two different classifications: Angelini and Khatami's classification, and a new modified classification that was derived from Angelini and Khatami's classification. Some procedural details and clinical features of the patients with CAA were also investigated.

RESULTSCoronary dominance pattern was: 81.6% right coronary artery, 12.2% circumflex artery and 6.2% co-dominant. IMA was present in 613 (11.0%) patients. The incidences of overall anomaly were 2.7% and 1.4%, according to the different classifications. Absent left main coronary artery, which was the most common anomaly in the present study, was found in 51 (0.9%) patients. Incidences of myocardial bridge, coronary arteriovenous fistulae and aneurysms were 1.1%, 0.2% and 0.3%, respectively.

CONCLUSIONCAAs are generally asymptomatic, isolated lesions. Some may lead to anginal symptoms, myocardial infarction or sudden death. We found that CAA was associated with increased radiation and contrast exposure in patients who underwent CAG. This risk could be reduced if appropriate catheters were designed and training programmes on ostial cannulation were developed.

Adult ; Aged ; Anatomic Variation ; Aneurysm ; Arteriovenous Fistula ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnosis ; Coronary Vessel Anomalies ; diagnosis ; surgery ; Coronary Vessels ; anatomy & histology ; surgery ; Death, Sudden ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction ; Myocardium ; pathology ; Retrospective Studies

Coronary artery anomalies are rare, and their incidence varies from 0.6% to 1.3%. Conventional angiography is a commonly used modality for the assessment of coronary artery anomalies, but it may not identify and define the anatomy of anomalous arteries due to the complexity of the course and three-dimensional orientation of the arteries. We present a rare case of duplicated right coronary artery (RCA) with separate ostium on 64-row multidetector computed tomography (MDCT). MDCT is better than conventional angiography in cases where selective catheterisation of either a single artery or ostium during catheter angiography has resulted in missing an important vessel. So far, 13 cases of duplicated RCA have been reported in the literature, and the features on MDCT were described only in three cases.
Catheters ; Coronary Angiography ; Coronary Vessel Anomalies ; diagnostic imaging ; Coronary Vessels ; anatomy & histology ; physiopathology ; Diagnostic Imaging ; methods ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods ; Vascular Malformations ; diagnosis

OBJECTIVE: To validate the optimal cardiac phase and appropriate acquisition window for three-dimensional (3D) whole-heart coronary magnetic resonance angiography (MRA) with a steady-state free precession (SSFP) sequence, and to compare image quality between SSFP and Gd-enhanced fast low-angle shot (FLASH) MR techniques at 1.5 Tesla (T). MATERIALS AND METHODS: Thirty healthy volunteers (M:F = 25:5; mean age, 35 years; range, 24-54 years) underwent a coronary MRA at 1.5T. 3D whole-heart coronary MRA with an SSFP was performed at three different times: 1) at end-systole with a narrow (120-msec) acquisition window (ESN), 2) mid-diastole with narrow acquisition (MDN); and 3) mid-diastole with wide (170-msec) acquisition (MDW). All volunteers underwent a contrast enhanced coronary MRA after undergoing an unenhanced 3D true fast imaging with steady-state precession (FISP) MRA three times. A contrast enhanced coronary MRA with FLASH was performed during MDN. Visibility of the coronary artery and image quality were evaluated for 11 segments, as suggested by the American Heart Association. Image quality was scored by a five-point scale (1 = not visible to 5 = excellent). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were evaluated at the proximal coronary arteries. RESULTS: The SSFP sequence rendered higher visibility coronary segments, higher image quality, as well as higher SNR and CNR than the Gd-enhanced FLASH technique at 1.5T (p < 0.05). The visibility of coronary segments, image quality, SNR and CNR in the ESN, MDN and MDW with SSFP sequence did not differ significantly. CONCLUSION: An SSFP sequence provides an excellent method for the 3D whole-heart coronary MRA at 1.5T. Contrast enhanced coronary MRA using the FLASH sequence does not help improve the visibility of coronary segments, image quality, SNR or CNR on the 3D whole-heart coronary MRA.
Adult ; *Contrast Media ; Coronary Vessels/*anatomy & histology ; Female ; Gadolinium/diagnostic use ; Humans ; Image Processing, Computer-Assisted ; *Imaging, Three-Dimensional ; Magnetic Resonance Angiography/*methods ; Male ; Middle Aged ; Organometallic Compounds/*diagnostic use ; Reference Values ; Young Adult