Coronary Artery CT Angiography in Coronary-pulmonary Fistula:A Retrospective Study

Objective: To investigate the clinical value of coronary CT angiography in detection of coronary-pulmonary artery fistula (CPF). Materials and Methods: Thirteen patients with the diagnosis of CPF were enrolled in this study. All the patients were performed with retrospective ECG-gated coronary CTA, including 8 males and 5 females (age range, 53-71 years, mean age, 62 years old). The heart rate ranged from 61 to 73 bpm. All the raw data were reconstructed with VR, MIP, MPR and CPR, and all the CPF were retrospectively analyzed. Results: In all 13 patients with CPF, 7 were fed with unilateral coronary artery, while the number of bilateral coronary blood supply was 6. The main feeding artery was proximal left anterior descending in 8 patients (61.5%). All CPF demonstrated dilated vascular coat presenting as "clustering shape" on the surface of the heart. All 13 patients demonstrated dilated feeding artery, 7 with "jet sign" in pulmonary artery fistula, while "smoking sign" were demonstrated in 6 patients. 5 aneurysms were detected in the feeding artery, and 9 feeding artery were found stenosis in the proximal point. Conclusion: Coronary CT angiography demonstrates capability in the diagnosis of CPF with characteristic imaging features of"clustering vessel coat" and "jet" sign.