Type:
Educational Exhibit
Keywords:
Arteriosclerosis, Normal variants, Diagnostic procedure, CT-Angiography, CT, Cardiac, Arteries / Aorta, Anatomy
Authors:
V. M. C. F. Muro Paz1, L. Falcon1, N. Angulo Carvallo1, R. Hammond Castro2; 1Lima/PE, 2Lima 31, Lima/PE
DOI:
10.1594/ecr2018/C-2139
Background
Early recognition of coronary artery disease (CAD) is important for the prevention of its related complications and improving prognosis.1 Invasive Coronary Angiography (ICA) is regarded as gold standard for the anatomical assessment of CAD:
* Advantages:
- High spatial and temporal resolution.
- Diagnostic and treatment purposes.
* Disadvantages:
- No information about the vessel wall or atheroma.
Bearing in mind the above considerations,
coronary computed tomography angiography (CCTA) is an excellent tool in the evaluation of patients with CAD,
even in the assessment of patients presenting with acute chest pain.
CCTA has proven to have high accuracy for detection of obstructive CAD and high negative predictive value,
which determines that CCTA as an effective noninvasive method to rule out obstructive CAD.1 CCTA allows visualization of the vessel lumen but also allows the radiologist to evaluate vessel wall and surrounding soft tissues.2,3
Coronary arteries can be highly variable in configuration or number. Some authors proposed that when coronary pattern presents in > 1% of frequency in an unselected general population,
it can be considered “normal”. Consequently,
features that are encountered in less than 1% of the general population are so called coronary artery anomalies.4
The main objective of the Coronary Artery Disease Reporting and Data System (CAD-RADS) is to standardize the report terminology for coronary CTA performed on patients with clinical suspicion or diagnosed with CAD,
this way diagnostic errors will be reduced through effective communication to referring physicians.5