590 KCR 2019

Cardiovascular

Cardiovascular

SE 03 CV-01Congenital anomalies of the coronary sinus: overlooked anatomy of cardiac imagingGeonyang Lee, Se Hwan Kwon, Joo Hyeong Oh, Jehong Yoon Kyung Hee University Medical Center, Korea. Kwon98@khu.ac.kr

BACKGROUND: Congenital anomalies of the coronary sinus (CS) tend to be overlooked because they rarely effect clinical symptoms or cardiac function. As the imaging technique has developed, it enabled the evaluation of detailed cardiac anatomy including CS.TEACHING POINTS: 1. To describe the cardiac venous system and its

embryologic development.2. To review congenital anomalies of the CS with multi-

detector computed tomography (MDCT) findings.TABLE OF CONTENTS/OUTLINE 1. Introduction and purpose2. Normal anatomy and embryologic development of the

cardiac venous system3. Congenital anomalies of the CS 1) Enlargement of the CS 2) Absence of CS 3) Atresia of the right atrial coronary sinus ostium 4) Hypoplasia of the coronary sinus4. Conclusion

SE 03 CV-02Troponin-positive nonobstructive coronary arteries (TpNOCA) and myocardial infarction with nonobstructive coronary arteries (MINOCA): definition, etiologies and CT and MR findings Sowon Jang1, Jeong A Kim2, Seung Min Yoo3, Eun Ju Chun1 1Seoul National University Bundang Hospital, 2Inje University Ilsan Paik Hospital, 3CHA University, CHA Bundang Medical Center, Korea. drejchun@hanmail.net

TEACHING POINTS: 1. To understand the definition and differential points

of Troponin-posit ive nonobstructive coronary arteries (TpNOCA) and myocardial infarction with nonobstructive coronary arteries (MINOCA)

2. To recognize the causes of TpNOCA: 1) Coronary disorders (MINOCA), 2) myocardial disorders, 3) non-cardiac disorders

3. To identify multimodality imaging findings of various

causes of TpNOCA and MINOCA4. To discuss the potential role of CT and MR for

evaluation of TpNOCA and MINOCATABLE OF CONTENTS/OUTLINE: 1. Definition and differential point of TpNOCA and

MINOCA2. Various causes and mechanism of TpNOCA and

MINOCA according to the location 1) Coronary lesions (MINOCA) 2) Myocardial lesions 3) Non-cardiac lesions3. Multimodality imaging findings of various causes of

TpNOCA and MINOCA 1) Coronary lesions: a. coronary spasm, b. coronary

dissection, c. plaque disruption or fissuring, d. microvascular angina, e. coronary vasculitis

2) Myocardial disorders: a. myocarditis, b. stress-induced card iomyopathy, c . hyper t rophic cardiomyopathy, d. dilated cardiomyopahty, e. other cardiomyopathy

3) N o n - c a r d i a c d i s o r d e r s : a . p u l m o n a r y thromboembolism, b. aortic dissection or intramural hematoma, c. tumor with pulmonary vessel invasion

- Systemic or others: thrombophilia syndrome, stroke, septic shock, renal impairment

4. Potential role of cardiac CT for evaluation of TpNOCA5. Potential role of cardiac MR for evaluation of MINOCA6. Summary table

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SE 03 CV-03Contrast-enhanced ultrasound for carotid artery plaqueYeo Koon Kim, Sang Il Choi Seoul National University Bundang Hospital, Korea. yeokoon.kim@gmail.com

TEACHING POINTS:1. The readers will learn how to do the carotid contrast-

enhanced ultrasound and how to quantify the plaque enhancement.

2. The readers will review the cases of carotid contrast-enhanced ultrasound.

TABLE OF CONTENTS/OUTLINE:1. Value of contrast-enhanced ultrasound (CEUS) for

vascular evaluation1) Enhancement of lumen: better visualization of

plaque surface and ulceration2) Enhancement of plaque: plaque vulnerability3) Introduction of an ongoing study to evaluating the

prognostic value of plaque enhancement on carotid CEUS in acute stroke patients (NCT03283306)

2. How to do carotid CEUS1) Preparation: intravenous catheter, informed

consent2) Carotid Doppler ultrasound3) Injection of ultrasound contrast: twice bolus

injections for bilateral carotid arteries4) Carotid CEUS: lumen and plaque enhancement5) Quantification of plaque enhancement: quantifi-

cation with software3. Review of current status and limitations of carotid

CEUS

SE 03 CV-04Pericardial recess: CT findings on variable disordersJinho Seo, Young Tong KimSoon Chun Hyang University Cheonan Hospital, Korea. bred897@naver.com

A pericardial recess is frequently seen in patients with chest computed tomography (CT). It is important to be aware of the normal anatomy of the pericardium. Because it is often mistaken for normal variants and disease. So we will describe the anatomy and location of the pericardial recess and what specific characteristic findings may be seen when a disease develops in the pericardial recess. Liquid retention of the pericardium can vary in size depending on the time of the scan or the respiration state. In addition, there may be an increase in pericardial effusion or a change in size depending on the size of the heart. Pericardial effusion, pericarditis, constrictive pericarditis, pericardial tumors can be seen

in the pericardial sinuses and recesses. In the following, the location of each pericardial recess will be described and the clinical significance of the pericardial recess by examining the related variants.

592 KCR 2019

Cardiovascular

SE 03 CV-05Cardiothoracic vasculitis versus mimickers: CT and MR featuresYura Ahn, Hyun Jung Koo, Joon-Won Kang, Dong Hyun Yang Asan Medical Center, Korea. elfin19@gmail.com

INTRODUCTION: Clinical spectrum of cardiothoracic involvement of vasculitis. The role of cardiac CT and MRI in assessment of vasculitisCT and MR features of typical and atypical cardiothoracic vasculitis, based on 2012 CHCC classification 1) Large vessel vasculitis - Takayasu arteritis - Giant cell

arteritis 2) Medium vessel vasculitis - Polyarteritis nodosa -

Kawasaki disease 3) Small vessel vasculitis - Antineutrophil cytoplasmic

antibody (ANCA)-associated vasculitis - Eosinophilic granulomatosis with polyangiitis - Immune complex small vessel vasculitis - IgA vasculitis

4) Variable vessel vasculitis - Behcet's disease 5) Vasculitis associated with systemic disease - Lupus

vasculitis 6) Drug-associated vasculitis CT and MR features of vasculitis mimickers and distinguishing points from vasculitis Moyamoya syndrome (Peripheral pulmonary artery stenosis in homozygosity of RNF213 p.Arg4810Lys) - Segmental arterial mediolysis - Intramural hematoma - Antiphospholipid syndrome - Retroperitoneal fibrosis - Infectious aortitis - Fibromuscular dysplasia

SE 03 CV-06CT for injuries of heart and aortaJi eun Park, Yeo Koon Kim, Sang Il Choi Seoul National University Bundang Hospital, Korea. yeokoon.kim@gmail.com

TEACHING POINTS: 1. The readers will learn the evaluation process for

thoracic injury patients in the emergency room.2. The readers will review the various imaging findings

of heart and aortic injuries.TABLE OF CONTENTS/OUTLINE:1. Cardiac injury

1) Pathophysiology of cardiac injury2) Cardiac injury scale3) Evaluation of cardiac injury: cardiac enzyme,

electrocardiogram, echocardiography, chest radiograph, CT angiography, coronary CT

angiography4) Review of cases: myocardial contusion, myocardial

rupture, chordal rupture, myocardial infarction secondary to coronary artery thrombosis, pericardial rupture, hemopericardium and cardiac tamponade.

2. Aortic injury1) Pathophysiology of aortic injury2) Grade of traumatic aortic injury3) Evaluation of aortic injury: chest radiograph and CT

angiography4) Review of cases: intimo-mediate tear, dissection,

transaction, pseudoaneurysm, chronic posttrau-matic pseudoaneurysm, hemopericardium and cardiac tamponade.

SE 03 CV-07CT evaluation of congenital heart disease: A step-wise approachJuhi Agrawal, Neha Antil, Pooja Jain, Mahesh Kumar Mittal, Maninder Kaur, Rekha Tanwar VMMC & Safdarjung Hospital, India. guptad45@gmail.com

BACKGROUND: Understanding complex cardiac anomalies have always been challenging for the both Radiologists and Physicians. The Van Praagh Class i f icat ion system has lead a systemat ic , comprehensively accepted step-wise approach for diagnosing congenital heart disease. It comprises of a three part notation representing the three steps of segmental approach; visceroatrial situs (S, I, A), ventricular looping (D or L loop) and position and relation of the great vessels (S, I, D-TGV, L-TGV, D-MGV, L-MGV). Following these steps meticulously in reporting room can help Radiologists to achieve accurate interpretation and thus facilitate better communication with the treating physicians.AIMS AND OBJECTIVES:1. Describe Congenital heart disease by using step wise

approach of Van Praagh system.2. Discuss the significance of pre-surgical imaging

evaluation of congenital heart disease.

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IMAGING FINDINGS: A wide variety of cases were collected and evaluated using this segmental approach including Tetralogy of Fallot, total anomalous pulmonary venous drainage, Ebstein’s anomaly, unilateral absence of pulmonary arteries, Levo-TGA, patent ductus arteriosus and many more. CT imaging helps in

preoperative evaluation for understanding the normal as well as variant vascular anatomy including vascular slings which may compress the airways and thus hamper postoperative recovery. Presence of cardiac and extracardiac associations including septal defects, patent ductus arteriosus, dilated bronchial arteries or major aortopulmonary collateral arteries (MAPCA’s) should be reported as they have surgical implications. Embolization of these collateral pathways is essential to prevent iatrogenic hemorrhage. CT imaging simultane-ously helps in assessing the pulmonary parenchyma including the features of pulmonary arterial/venous hypertension. Interpretation of one of our cases using the three-step approach has been given in the illustration attached.CONCLUSION: The Van Praagh Classification system has been substantiated as a problem-solving tool for accurate interpretation of even complex cardiac anomalies.

SE 03 CV-08Relationship between echocardiographic left atrial parameters and atrial fibrillation recurrence after DCCOyuka Erka, Enkhtaivan NamuuntsetsegFriendship Naran Diagnostic Center, Mongolia. oyukaerka1991@gmail.com

BACKGROUND: Determining predictors of atrial f ibr i l lat ion (AF) recurrence after direct current cardioversion (DCC) using simple echocardiographic left atrial (LA) parameters may be useful in tailoring treatment strategies.PURPOSE: In this study, we aimed to reveal relationship between echocardiographic LA parameters and AF recurrence after DCC.MATERIALS AND METHODS: We prospectively selected patients with persistent AF who planned direct current cardioversion to restore normal sinus rhythm (NSR). Biphasic external defibrillator was used for current delivery. The 2 dimensional echocardiographic LA parameters such as LA diameter, length, area, volume and LA volume index (LAVI) were measured from apical 4 chamber and 2 chamber view and average values obtained.RESULTS: Fifteen patients with AF who treated by DCC and restored NSR were studied (mean age, 55 ± 9, 93% male). After successful DCC, patients were followed-up to AF recurrence and median follow-up was 9.1 months (IQR 3.2; 10.2). LA diameter (4.0 ± 0.45 cm vs. 5.0 ± 0.95 cm, p < 0.05) and LAVI (25.6 ± 6.9 mL/m2 vs. 56.6 ± 25.4 mL/m2, p < 0.05) were significantly different between sinus rhythm group and AF recurrence group. In univariable regression, however, only LAVI

594 KCR 2019

Cardiovascular

was associated with AF recurrence (OR = 1.19, 95% CI 1.01-1.40, p < 0.05).CONCLUSION: In this study, we found that LAVI is simple echocardiographic parameter to predict AF recurrence after successful DCC.

SE 03 CV-09Congenital vascular anomalies in newborn or young childrenJonan Chun Yin Lee Queen Elizabeth Hospital, Hong Kong. jonanleecy@yahoo.com

Anatomical variants of aortic arch and its branches are relatively common, the majority of them are clinically insignificant. However, several congenital vascular rings and slings may cause severe respiratory or gastrointestinal symptoms due to their compression on the trachea and esophagus. CT and MR imaging are of immense clinical value in the anatomical delineation of suspected vascular ring anomalies. A knowledge of embryology is essential in our understanding of vascular rings. Clinical cases of aortic arch anomalies confirmed by CT or MRI in a tertiary referral center in Hong Kong are reviewed. Clinical significant vascular anomalies including double aortic arch, right aortic arch with aberrant left subclavian artery and pulmonary sling are illustrated with CT or MRI images. Important imaging findings with clinical significance, such as the presence of Komerrell’s diverticulum, will be discussed. The clinical progress and outcome of affected patients are also discussed.

SE 03 CV-10Review of clinical and imaging findings of cardiac involvement of Kawasaki diseaseHyun gun Kim, Jehong Yoon, Se Hwan Kwon, Joo Hyeong Oh Kyung Hee University Medical Center, Korea. sphkyo@gmail.com

Kawasaki disease is an acute systemic vasculitis that is the most common cause of acquired heart disease seen in childhood in developed countries. Coronary artery aneurysms are the most serious complication of Kawasaki disease. Coronary artery aneurysm or ectasia develops in about 15% to 25% of patients. Periodic follow-up examinations are of vital importance because these aneurysms may cause sudden death or ischemic heart disease due to thrombotic or stenotic occlusion of the coronary arteries.In this review, we will review the epidemiology, etiology and pathogenesis, histopathology, clinical features,

cardiovascular complications, and imaging, focusing on the role of cardiac CT and CAG on the initial assessment and follow-up of the cardiovascular complications of Kawasaki disease.

SE 03 CV-11Clinical applications of wide-detector CT scanner for cardiothoracic imaging: an updateEun-Ju Kang, Moonsung Kim, Hyunjin Kim, Ki-Nam Lee Dong-A University Hospital, Korea. medcarrot@naver.com

BACKGROUND: Multidetector computed tomography (MDCT) has rapidly developed and a 64-detector CT scanner is an acceptable imaging modality for non-invasive assessment of coronary arteries. The major difficulties of MDCT for cardiac imaging are restricted temporal and spatial resolution and limited z-axis coverage which could produce stair-step artifacts. With development of wide-area coverage (16 cm) CT scanner, it enables volumetric imaging of the entire heart within one cardiac cycle free of stair-step artifacts. These improvements provide not only better diagnostic performance of CT coronary angiography, but also lower radiation dose and contrast media. Additionally, new imaging technics for the cardiothoracic area, including transluminal attenuation gradient, subtraction imaging, and free-breathing scan, have been developed and more improved by using the wide-detector CT scanner. In this exhibition, we investigates the technical aspects of wide-detector CT scanners and suggests potential clinical applications and benefits of them in the cardiothoracic imaging area.PURPOSE/AIM: 1. To review the technical aspects of wide detector CT

scanner2. To review the major strength of wide detector

CT scanner, and discuss clinical application in cardiothoracic imaging.

CONTENT ORGANIZATION: 1. Technical aspects of wide-detector CT scanner

system1) Development of wide-detector MDCT2) Imaging parameters of commercially available

wide-detector CT scanner3) Contrast media and radiation dose

2. Application of wide-detector CT on cardiothoracic imaging1) Volumetric myocardial imaging: Function and

perfusion2) Transluminal attenuation gradient3) Triple rule-out scan and pulmonary vascular

imaging4) Transcatheter aortic valve implantation evaluation

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5) Pediatric cardiothoracic imaging6) Challenging techniques in cardiothoracic imaging:

free-breathing scans and subtraction imaging3. Conclusion

SE 03 CV-12Direct CT venography of upper limb venous system: an experience of technique and findings in ESRD patients of Burapha University HospitalSuchanun Osatheerakul1, Sornsupha Limchareon2 1Burapha University Hospital, 2Dӣῑsῑon of Radiology and Nuclear Medicine, Faculty of Medicine, Burapha University, Thailand. oil_tu72@hotmail.com

PURPOSE: To describe our experience in performing direct CT venography (CTV) of the upper limb venous system and the findings in end-stage renal disease patients (ESRD).MATERIALS AND METHODS: We retrospectively reviewed the techniques of CTV and findings in ESRD patients who underwent CTV of both upper limbs between 1st November 2013 and 31st March 2019. RESULTS: Direct CTV technique in our hospital was performed using the 64-MDCT scanner with simultaneous injections of diluted contrast material 1:4 at both elbows and scanning 2 phases included direct venous phase at 7 sec after injection and subsequently repeated phase (around 20-25 sec). The total amount of contrast was 38 ml. There were 40 CTV examinations. A total of 600 venous segments were studied. A number of lesions found in one patient ranged from 1 to 6 lesions. The majority of patients had 1 to 3 lesions (30 out of 38). Stenosis and thrombosis were equally the two most common findings, total of 112 out of 600 segments. The three most common sites of steno-occlusive complication were brachiocephalic vein (29 lesions), internal jugular vein (25 lesions) and subclavian vein (16 lesions). The most common site of stenosis was brachiocephalic vein (18 lesions) whereas the most common site of thrombosis was internal jugular vein (20 lesions). There was no venous aneurysm or rupture in our finding. Extravasation of contrast medium at the site of injection in one arm was shown in one patient.CONCLUSION: Our direct CTV technique has the benefit of using less amount of contrast medium while maintains direct visualization of the venous system similar to conventional venography.

SE 03 CV-13Defining location of coronary artery stenosis by studying with coronary CT angiography Tungalagtamir Khurelbaatar1, Badamsed Tserendorj2 1MRS, 2Institute of Medical Sciences and State Third Central Hospital of Mongolia, Mongolia. tamiraa0329@yahoo.com

PURPOSE: To define the location of coronary artery stenosis of Mongolian people by studying with coronary computed tomography angiography.MATERIALS AND METHODS: We made this research based on the materials of totally 101 analyzed people, who were involved in the coronary artery test of the heart with contrast dye with assistance CT Cabinet of the State 3rd Central Hospital of Mongolia from November of 2015 to February of 2017. Coronary artery stenosis has been detected in 33 people from 101 people involved in the examination. When considering coronary artery stenosis of 33 people by locations, left anterior descending coronary artery stenosis was detected 10 (30.3% ± 7.9), right coronary artery stenosis was 16 (48.5% ± 8.7) and left circumflex coronary artery stenosis was 7 (21.2% ± 7.1) both solely and combined. Cases of right coronary artery stenosis prevailed from coronary artery stenosis as covering 48.5% are showing statistical fact probability (p < 0.05). Case of left anterior descending coronary artery stenosis was detected from totally 10 cases 1 (10.0% ± 10.0) in the 1st segment, 3 (30.0% ± 15.3) in the 2nd segment and 6 (60.0 ± 16.3) in the 3rd segment. It shows that left anterior descending coronary artery stenosis cases are found predominantly in the 3rd segment (p < 0.01). From 16 cases of right coronary artery stenosis, it was found 3 (18.75% ± 10.1) in the 1st segment, 4 (25.0% ± 11.2) in the 2nd segment and 9 (56.25 ± 12.8) in the 3rd segment. It shows that right coronary artery stenosis cases are found predominantly in the 3rd segment (p < 0.05). From 7 cases of left circumflex coronary artery stenosis, it was found 2 (28.57% ± 18.44) in the 1st segment and 5 (71.43% ± 18.44) in the 2nd segment. Therefore, left circumflex coronary artery stenosis has statistical fact probability (p < 0.05), because these cases were prevailed in the 2nd segment. It has been combined with 2 of LAD+ 2 of RCA, 2 of LAD +3 of RCA, 1-3 of LAD + 2-3 of RCA, 2-3 of RCA + 1-2 of LCX. It is defined that right coronary artery stenosis was prevailed in the 48.5% as solely and combined from all coronary artery stenosis cases.Right coronary artery and left anterior descending coronary artery stenosis cases were prevailed in the 60% in the 3rd segment and left circumflex coronary artery stenosis cases were prevailed in 71.43.% in the 2nd segment.

596 KCR 2019

Cardiovascular

SE 03 CV-14Aortocaval fistula: a rare complication of abdominal aorta aneurysmNur Aimi Ngah1, Suraya Aziz1, Wan Muhammad Nazief2

1Universiti Kebangsaan Malaysia Medical Center, 2Hospital Kuala Lumpur, Malaysia. aimingah83@hotmail.com

INTRODUCTION: Aortocaval f is tu la is a rare complication of abdominal aorta aneurysm (AAA). The clinical presentation is often obscure. Prompt preoperative diagnosis is essential to plan operative approach. Computed tomography angiogram (CTA) is diagnostic in majority of cases. We report a case of a patient presented with cardiac symptoms due to aortocaval fistula.CASE PRESENTATION: A 72 years-old gentleman presented with worsening shortness of breath and dry cough for 3 days. He also had heart failure symptoms for 6 months and defaulted his anti-hypertensive medications for 1 year. Biochemically, he had acute on chronic renal impairment with metabolic acidosis. Chest radiograph showed cardiomegaly. Bedside ultrasonography of abdomen showed abdominal aorta aneurysm. CTA showed presence of aortocaval fistula complicating AAA with massive left-to-right shunt. Patient underwent emergency open repair of the aortocaval fistula and AAA and showed clinical improvement.DISCUSSION: Aortocaval fistula is a rare complication of AAA. Most cases are due to spontaneous erosion of AAA into adjacent venous structures. Clinical presentation may be asymptomatic but often vague and mimicking cardiovascular symptoms. Venous hypertension due to left-to-right shunt from aortocaval fistula lead to other complications for example heart failure, acute pulmonary edema or recurrent pneumonia. CTA of aorta helps to further evaluate the AAA and its coexisting aortocaval fistula complication.CONCLUSION: Aortocaval fistula should be considered as a possible diagnosis in a patient who presented with heart failure symptoms with concurrent AAA. CTA is the best modality of imaging to further evaluate the AAA. Emergency surgical repair can significantly improve the clinical outcome.

SE 03 CV-16Retrospective study of anomalies, stenosis and occlusion of coronary arteries in CT coronary angiogram studies performed for acute or non-acute chest painOm Biju Panta, Bibeck Gurung, Babin Basnet, Ram Kumar Ghimire, Bhuwan Kayastha Nepal Mediciti Hospital, Nepal. bijupanta@yahoo.com

INTRODUCTION: CT coronary angiography is currently accepted investigation in diagnosis of acute or non-acute coronary arterial disease, stent and bypass evaluation. However, this test is used in low risk and non-acute conditions more frequently than in acute coronary arterial disease. The test has proved to be very useful tool in patient with suspected unstable angina avoiding hospitalization and extensive testing.PURPOSE: The aim of this study was to review indications for CT coronary angiography, evaluate incidence and type of anomalous coronary arteries encountered and access and characterize vessel stenosis.MATERIALS AND METHODS: The study was a retrospective Hospital record-based analysis of all CT coronary angiograms performed during last one-year period from 2018 January to 2018 December in our Hospital. CT coronary angiograms were reviewed from PACS and indication for study, dominance, calcium scoring, anomalies of coronary artery origin and vessel stenosis was evaluated.RESULTS: We evaluated total 50 patients studied during that period, out of which 4 study was done to evaluate shunt, 2 study was done to evaluate stents and rest of the study were to evaluate chest pain 23 were done for evaluation of acute chest pain and 21 was done for exertional and non-acute pain. Three of the studies suffered from motion artefact, two of which required conventional angiography due to non-diagnostic image quality, in one of the study all vessels could be well evaluated segmentally. Out of 50, 7 (14%) patient demonstrated some anomaly in coronary arteries, superficial myocardial bridging of LCA being the commonest. 13 (26%) of the patients had positive study with some degree of stenosis, 26 (52%) neither had stenosis or any coronary anomalies.CONCLUSION: CT coronary angiogram is a rapid and fairly accurate study and can solve problems without the need for invasive angiography.

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SE 03 CV-17Single coronary artery: an extremely rare congenital anomalyTushar Suvra Ghosh1, Saugata Sen1, Bhavik Parmar2, Dayananda Lingegowda1, Sumit Mukhopadhyay1, Aditi Chandra1 1Tata Medical Center, 2Batra Hospital & Medical Research Center, India. tusharradio@gmail.com

INTRODUCTION: A single coronary artery (SCA) is a rare congenital anomaly of the coronary arteries, which is described as one coronary artery arising from the aortic trunk by a single coronary ostium and providing for perfusion of the entire myocardium. The prevalence of SCA is approximately 0.024% to 0.066% in population who undergo coronary angiography.AIMS AND OBJECTIVES: Illustration of anomalous coronary artery origin by coronary CT angiography (CTA).MATERIALS AND METHODS: Coronary CTA was done for evaluation of unexplained chest pain using a 64-MDCT. Following image acquisition, the images are reconstructed by using a medium soft-tissue kernel with retrospective ECG gating and displayed into various 3D and multiplanar reformatted views.RESULTS AND DISCUSSION: On coronary CTA, we found a single right coronary artery arised from right anterior coronary sinus and coursed in the normal anatomic position of right coronary artery. No main left coronary artery (LCA) was seen to arise from left coronary sinus. An anomalous thin artery was noted to be arising from single right coronary artery just after its origin from right coronary sinus and coursed as LCA. It gave LAD and LCX branches. We classified this anomaly as RII-A as it took its origin from right sinus of Valsalva and a thin left coronary artery, arised from proximal portion of normally located right coronary artery coursed anterior to the great vessels (non-malignant course).CONCLUSION: SCA is extremely rare coronary artery congenital anomaly with approximately 0.024% to 0.066% prevalence in population who undergo coronary angiography. Coronary CTA provides accurate angiographic information on the origin, course, and termination of coronary anomalies noninvasively.

598 KCR 2019

Cardiovascular

Cardiovascular-Informal Scientific Presentation

Presenting No.

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ISP 05_CV 01 SE 03 CV-11 Clinical applications of wide-detector CT scanner for cardiothoracic imaging: an update Hyunjin Kim 594