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Nonatherosclerotic Cardiovascular Findings on MDCT Coronary Angiography: A Selection of Abnormalities

Mark T. T. Takaki1, Theodore J. Dubinsky1, Bill H. Warren1, Lee Mitsumori1 and William P. Shuman1

1 All authors: Department of Radiology, Body Imaging Section, University of Washington Medical Center, 325 Ninth Ave., Box 359728, Seattle, WA 98104.


Figure 1
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Fig. 1A MDCT angiography images in 67-year-old woman with acute coronary syndrome. Volume-rendered image shows interarterial course of proximal right coronary artery (RCA) arising from left coronary sinus.

 

Figure 2
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Fig. 1B MDCT angiography images in 67-year-old woman with acute coronary syndrome. Caudal projection of volume-rendered image emphasizes interarterial or malignant course of anomalous RCA (arrow).

 

Figure 3
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Fig. 1C MDCT angiography images in 67-year-old woman with acute coronary syndrome. Sagittal oblique reconstruction shows RCA arising from left coronary sinus (arrow).

 

Figure 4
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Fig. 2A MDCT angiography images in 48-year-old man with incidentally noted myocardial bridge that was thought not to be symptomatic. Curved multiplanar reformation shows long segment of myocardial bridging (arrow) of mid left anterior descending artery (LAD).

 

Figure 5
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Fig. 2B MDCT angiography images in 48-year-old man with incidentally noted myocardial bridge that was thought not to be symptomatic. Axial image shows intramyocardial course of mid LAD (arrow).

 

Figure 6
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Fig. 3A MDCT angiography images in 54-year-old woman with episode of chest pain and syncope. Volume-rendered images show coronary artery fistula from left circumflex artery to coronary sinus (arrows).

 

Figure 7
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Fig. 3B MDCT angiography images in 54-year-old woman with episode of chest pain and syncope. Volume-rendered images show coronary artery fistula from left circumflex artery to coronary sinus (arrows).

 

Figure 8
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Fig. 4 29-year-old man with repaired tetralogy of Fallot. Axial MDCT angiography image reveals retroaortic course of proximal left main coronary artery arising from right coronary sinus. Accessory left anterior descending artery is arising from left cusp as well (arrow).

 

Figure 9
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Fig. 5 58-year-old man with incidentally noted anomalous left circumflex artery (LCX). Curved multiplanar reformation of MDCT angiography image shows retroaortic course of proximal LCX arising from right coronary sinus (arrow). CIRC = circumflex artery.

 

Figure 10
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Fig. 6A MDCT angiography images in 43-year-old man with incidentally noted anomalous origin of left circumflex artery (LCX). Curved multiplanar reformation (A) and coronal oblique (B) images show subpulmonic course of proximal LCX arising from right coronary sinus (arrows).

 

Figure 11
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Fig. 6B MDCT angiography images in 43-year-old man with incidentally noted anomalous origin of left circumflex artery (LCX). Curved multiplanar reformation (A) and coronal oblique (B) images show subpulmonic course of proximal LCX arising from right coronary sinus (arrows).

 

Figure 12
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Fig. 7A MDCT angiography images in 24-year-old man with congenital aortic stenosis. Curved multiplanar reformations reveal small saccular aneurysm arising from proximal left main artery (arrows).

 

Figure 13
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Fig. 7B MDCT angiography images in 24-year-old man with congenital aortic stenosis. Curved multiplanar reformations reveal small saccular aneurysm arising from proximal left main artery (arrows).

 

Figure 14
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Fig. 8A MDCT angiography images in 19-year-old man with history of Kawasaki's disease. Volume-rendered images show giant diffuse aneurysms of right and left coronary arteries.

 

Figure 15
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Fig. 8B MDCT angiography images in 19-year-old man with history of Kawasaki's disease. Volume-rendered images show giant diffuse aneurysms of right and left coronary arteries.

 

Figure 16
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Fig. 9A MDCT angiography images in 25-year-old man who awoke with chest pain. Curved multiplanar reformations reveal spontaneous left anterior descending artery (LAD) dissection presenting as eccentric stenosis of mid LAD (arrows).

 

Figure 17
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Fig. 9B MDCT angiography images in 25-year-old man who awoke with chest pain. Curved multiplanar reformations reveal spontaneous left anterior descending artery (LAD) dissection presenting as eccentric stenosis of mid LAD (arrows).

 

Figure 18
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Fig. 10A MDCT angiography images in 44-year-old woman with acute monocytic leukemia and left atrial thrombus. Volume-rendered image shows left atrial mass (arrow) without calcifications. Inset shows plane of reconstruction.

 

Figure 19
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Fig. 10B MDCT angiography images in 44-year-old woman with acute monocytic leukemia and left atrial thrombus. Axial image shows that left atrial mass (arrow) is contiguous with atrial septum.

 

Figure 20
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Fig. 11A MDCT angiography images in 43-year-old man with calcified right atrial myxoma. Axial image reveals several calcifications in mass (arrow).

 

Figure 21
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Fig. 11B MDCT angiography images in 43-year-old man with calcified right atrial myxoma. Sagittal reconstruction shows calcified right atrial mass (arrow).

 

Figure 22
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Fig. 12 22-year-old woman with hypoxia. Coronal short-axis reconstruction of MDCT angiography image shows high membranous ventral septal defect (arrow) and right ventricular hypertrophy.

 

Figure 23
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Fig. 13A MDCT angiography images in 31-year-old man with heart murmur. Maximum-intensity-projection (A) and axial (B) images show noncalcified bicuspid aortic valve with poststenotic dilation of ascending thoracic aorta (arrows). Note minimal left ventricular hypertrophy.

 

Figure 24
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Fig. 13B MDCT angiography images in 31-year-old man with heart murmur. Maximum-intensity-projection (A) and axial (B) images show noncalcified bicuspid aortic valve with poststenotic dilation of ascending thoracic aorta (arrows). Note minimal left ventricular hypertrophy.

 

Figure 25
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Fig. 14A MDCT angiography images in 59-year-old woman with patent ductus arteriosus (PDA) and Eisenmenger's syndrome. Axial (A) and sagittal (B) oblique reconstructions show PDA (arrows) and enlarged main pulmonary artery. Contrast dilution is evidence for jet from PDA.

 

Figure 26
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Fig. 14B MDCT angiography images in 59-year-old woman with patent ductus arteriosus (PDA) and Eisenmenger's syndrome. Axial (A) and sagittal (B) oblique reconstructions show PDA (arrows) and enlarged main pulmonary artery. Contrast dilution is evidence for jet from PDA.

 

Figure 27
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Fig. 15A MDCT angiography images in 29-year-old woman with repaired tetralogy of Fallot. Sagittal oblique image shows repaired ventral septal defect (arrow).

 

Figure 28
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Fig. 15B MDCT angiography images in 29-year-old woman with repaired tetralogy of Fallot. Axial image reveals mild subvalvular pulmonic stenosis (arrow).

 

Figure 29
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Fig. 16A MDCT angiography images in 39-year-old man with repaired transposition of great vessels after Mustard-Senning procedure. Axial image shows portion of left atrium isolated by atrial baffle placed during Mustard-Senning procedure (arrow).

 

Figure 30
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Fig. 16B MDCT angiography images in 39-year-old man with repaired transposition of great vessels after Mustard-Senning procedure. Coronal image shows aorta arising from anterior right ventricle (arrow).

 

Figure 31
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Fig. 16C MDCT angiography images in 39-year-old man with repaired transposition of great vessels after Mustard-Senning procedure. Coronal image reveals contrast-enhanced superior vena cava (arrow) and nonenhancing inferior vena cava (arrow) flow into left atrium and subsequently into left ventricle as result of a baffle procedure.

 

Figure 32
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Fig. 17A MDCT angiography images in 29-year-old woman with repaired truncus arteriosus. Axial image reveals left pulmonary artery stent (arrow).

 

Figure 33
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Fig. 17B MDCT angiography images in 29-year-old woman with repaired truncus arteriosus. Axial images show main pulmonary artery (arrows) anterior to aorta.

 

Figure 34
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Fig. 17C MDCT angiography images in 29-year-old woman with repaired truncus arteriosus. Axial images show main pulmonary artery (arrows) anterior to aorta.

 

Figure 35
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Fig. 18A MDCT angiography images in 60-year-old man with history of coronary artery bypass grafting who presented with large mediastinal mass. Sagittal (A) and volume-rendered (B) images reveal giant thrombosed saphenous vein graft pseudoaneurysm (arrows). LIMA = left internal mammary artery.

 

Figure 36
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Fig. 18B MDCT angiography images in 60-year-old man with history of coronary artery bypass grafting who presented with large mediastinal mass. Sagittal (A) and volume-rendered (B) images reveal giant thrombosed saphenous vein graft pseudoaneurysm (arrows). LIMA = left internal mammary artery.

 

Figure 37
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Fig. 19 74-year-old man after mitral valve replacement. Axial MDCT angiography image reveals atrioventricular communication between left atrium and left ventricle (arrow).

 

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