Diagnosis of coronary artery fistulas by multi detector computed tomography

Tóm tắt

Objective: To evaluate the imaging characteristics of coronary artery fistulas (CAFs) by multidetector computed tomography (MDCT).
Materials and Methods: a prospective descriptivestudy from January 2019 to September 2020 enrolled 31 patients (11 males, mean age 56 years) detected CAFs on MDCT at Radiology Centre of Bach Mai hospital. The origin, size, and drainage site of CAFs were analyzed.
Results: 31 (0.93%) CAFs were detected with 3322 patients underwent CCTA. 18 (58.1%) patients had multiple fistulas and 13
(41.9%) patients had single communication. 6.5% originated from the right coronary, 35.5% from the left coronary artery system, and 58.5% from both the right and left coronary artery. 87.1% of fistulas drain to the right side of the circulation (74.2% drain to pulmonary artery). 1 patient (3.2%) had fistula drain to the left side of the circulation (bronchial
artery). 3 patients (9.7%) had fistulas drain to both the right and left side of the circulation (pulmonary artery and bronchial artery). 10 patients had large fistulas (32.3%), 21 patients had small fistulas (67.7%). 19 (61.3%) patients had an asscociated aneurysm of fistulas . 38.7% of cases were diagnosed with CAFs by echocardiography (38.7%). 6 patients were examined by CAG: 2 patients were not detected origin of fistulas by CAG, 3 patients were not detected drainage of fistulas by CAG.
Conclusion: DSCT is a noninvasive and useful modality for the diagnosis of CAFs.