E4937. Imaging of Nonatherosclerotic Coronary Artery Abnormalities: A Review
  1. Logan Weghorst; University of Toledo Medical Center
  2. Michael Walsh; University of Toledo Medical Center
  3. Haitham Elsamaloty; University of Toledo Medical Center
  4. Terrence Lewis; University of Toledo Medical Center
  5. Omar Gad; University of Toledo Medical Center
  6. Myles Keener; University of Toledo Medical Center
Coronary arterial abnormalities encompass a diverse range of cardiovascular malformations and are often divided into three distinct groups: abnormal origin/course, abnormal intrinsic coronary arterial anatomy, and abnormal coronary arterial termination. This case series provides an in-depth review of the classic imaging characteristics associated with several distinct pathological entities spanning these three major subdivisions. The increasing utilization of coronary CTA (CCTA) necessitates a greater sensitivity for and familiarity with these abnormalities as their identification becomes more prevalent. This series provides an additional unique perspective using high-resolution 3D virtual reconstructions, which serve to further elucidate the structural intricacy of the selected pathologies.

Educational Goals / Teaching Points
1. Communicate the current classification scheme for nonatherosclerotic coronary artery abnormalities. 2. Present the common imaging findings associated with multiple pathological coronary arterial entities, shown via CCTA, as well as high-resolution 3D reconstructions. 3. Explain the role of the radiologist in identification and communication of these abnormalities, as well as their clinical significance.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1) Anatomic/pathophysiologic issues: anomalous coronary arterial course/origin. Coronary arterial aneurysm, pseudoaneurysm, dissection, arteriovenous malformation (AVM), and fistulae. 2) Classic imaging findings of these pathologies as seen on CCTA and 3D reconstructions.

Overall, this case-based review underscores the growing importance of CCTA and the additional benefit of 3D reconstructions in the precise identification and characterization of a diverse array of coronary arterial abnormalities. Understanding the intricacies of these anomalies empowers the radiologist to play a pivotal role in the delivery of precise assessment and facilitation of patient-centered care.