Turhan YAVUZ, Mustafa ETLİ, Ahmet YEŞİLDAĞ, Mustafa KAYAN, Mehmet MUNDUZ, Ergun CEYLAN, Selçuk YAŞAR, Yasin TÜRKER

Evaluation of coronary artery anomalies using 128-Slice computed tomography

Amaç: Bu çalışmada 128 kesitli bilgisayarlı tomografinin (BT) anatomik koroner arter varyasyonlarını ve anomalilerini saptamadaki etkinliği araştırıldı ve elde edilen bulgular literatür verileri ile karşılaştırıldı. Çalışma planı: Şubat 2009 - Aralık 2010 tarihleri arasında kliniğimizde 128 kesitli BT ile değerlendirilen, şüpheli veya bilinen koroner arter hastalığı olan 83 hasta (58 erkek, 25 kadın; ort. yaş 53.7±10 yıl; aralık 31-80 yıl) retrospektif olarak incelendi. Tüm görüntüler, kardiyovasküler radyoloji alanında uzman bir radyolog tarafından anatomik varyasyon ve anomali açısından değerlendirildi. Sürekli değişkenler aritmetik ortalama ± standart sapma (SS) ile ifade edilirken, kategorik değişkenler yüzde (%) ile ifade edildi. Tanımlayıcı istatistiksel testler ile istatistiksel analiz yapıldı. Bulgular: Sağ dominans, sol dominans ve kodominans oranı sırasıyla %80.7, %8.4 ve %10.8 idi. Konus arterin %16.86 oranında sağ sinüs valsalvadan ve %83.1 oranında sağ koroner arterden (sağ KA) köken aldığı gözlemlendi. Sinüs nod arterin (SNA) %77.1 oranında sağ KA’dan, %18.1 oranında sirkumfleks (Cx) arterden, %2.4 oranında sol ana koroner arterden (sol ana KA) ve %2.4 oranında sağ sinüs valsalvadan köken aldığı belirlendi. Hastaların %30.12’sinde ramus intermedius mevcuttu. Kırk sekiz hastada (%57.8) koroner arter anomalisi saptandı. Bu hastaların %1.2’sinde sol ana KA noksanlığı; %6’sında komissural köken; %1.2’sinde koroner hipoplazi; %4.8’inde kontralateral sinüs köken anomalisi ve %43.3’ünde miyokard köprüsü mevcuttu. Sonuç: 128 kesitli BT, koroner arter varyasyonlarının ve anomalilerinin saptanmasında güvenilir, ayrıntılı ve doğru bilgi sağlayan invaziv olmayan bir yöntemdir. 128 kesitli BT’nin koroner arter anomalilerinin tanı ve cerrahi tedavisinde yüksek öneme sahip olduğu kanısındayız.

128 kesitli bilgisayarlı tomografi kullanılarak koroner arter anomalilerinin değerlendirilmesi

Background: In this study, we aimed to investigate the efficacy of a 128-slice computed tomography (CT) device in detecting anatomical variations and anomalies of coronary arteries and to compare the results obtained with literature data. Methods: Totally, 83 patients (58 males, 25 females; mean age 53.7±10 years; range 31 to 80 years) with suspected or known coronary artery disease who underwent evaluation using the 128-slice CT in our clinic between February 2009 and December 2010 were retrospectively analyzed. All images were evaluated in terms of anatomic variation and anomaly by a radiologist with expertise in cardiovascular radiology. Continuous variables were expressed as arithmetical mean ± standard deviation (SD), while categorical variables were expressed as percent (%). Statistical analysis was performed using descriptive statistical tests. Results: The rate of right dominance, left dominance and co-dominance was 80.7%, 8.4% and 10.8%, respectively. It was observed that the conus artery originated from the right sinus valsalva at a rate of 16.86% and from the right coronary artery (RCA) at a rate of 83.1%. It was found that sinus node artery (SNA) originated from the RCA at a rate of 77.1%, from the circumflex (Cx) artery at a rate of 18.1%, from the left main coronary artery (LMCA) at a rate of 2.4% and from the right sinus valsalva at a rate of 2.4%. Ramus intermedius was present in 30.12% of the patients. Coronary artery anomaly was observed in 48 patients (57.8%). of them, 1.2% had absence of LMCA, 6% had commissural origin, 1.2% had coronary hypoplasia, 4.8% had anomalous of contralateral sinus origin, and 43.3% had myocardial bridging. Conclusion: The 128-slice CT device is a non-invasive method which provides reliable, detailed and correct information for detecting variations and anomalies of coronary arteries. We believe that the 128-slice CT is of higher value in diagnosis and surgical therapy of coronary artery anomalies.

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