Objective: To make a pictorial presentation of the anomalous origin of left coronary artery arising from the pulmonary artery (ALCAPA) appearances in adults on MDCT angiography. Methods: A retrospective evaluation was performed between 2005 and 2011 by ECG-gated coronary MDCT angiography. Total 8 patients included (9-51 years, mean age 29 years, 7 female). Image quality was evaluated firstly. Multi planar reformations (MPRs), maximum intensity projections (MIPs) and 3D volume-rendering techniques were used to evaluate image features. In addition, right and left coronary artery orifices were measured for each case. Results: Total 8/70,000 cases diagnosed ALCAPA by MDCT exam, all image qualities were acceptable. As the diagnose key point, all left coronary artery origin were clearly described, and indirect signs such as dilated and tortuous right/left arteries and collateral vessels between them, enlarged left ventricle were also well showed, the dilated degree of both the RCA and the LCA were marked with ages, the diameter of RCA for each case were a mild wider than that of left one. Other combined signs like papillary muscle calcification, bronchial arteries from aorta to the cardiac and coronary artery degeneration change were also included by MDCT angiography findings in a single data acquisition. No combined inter cardiac malformations in our group. Conclusion: ECG-gated MDCT an-giography plays an important role as a first-line modality in assessment of ALCAPA.
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