Anatomic classification of coronary arteries in complete transposition of great arteries : diagnosis and analysis with multi-slice CT

Objective: To evaluate the diagnostic value of multi-slice spiral CT (MSCT) in classifying coronary arteries of complete transposition of great arteries (D-TGA). Methods: The clinical and imaging data of 367 patients with D-TGA who had undergone MSCT examination from March 2005 to June 2015 were retrospectively analyzed. The origin and course of the coronary arteries of the patients were classified according to the Marie Lannelongue classification. There were four patterns of courses: normal, looping, intramural and miscellaneous. And the four patterns were subdivided into eleven subgroups. The anatomic classification of coronary arteries in D-TGA were recorded, and the ratio of descriptive statistics was used according to categorical variable data. Results: All the origin and course of the coronary arteries could be clearly displayed on MSCT. Of 367 patients with D-TGA, 209 cases (56.95%) were normal course (type I), 138 cases (37.60%) were looping course (type II), 16 cases (4.36%) were intramural course (type n), and 4 cases (1.09%) were miscellaneous course (type IV). In looping course, the posterior looping (type II A), anterior looping (type II B) and double looping (type II C) were found in 63 cases (17.17%), 30 cases (8.17%) and 45 cases (12.26%), respectively. The ratios of the anatomic classification of looping courses were II A-144(11.99%), II A-2 19(5.18%), II B-1 12(3.27%), II B-2 8(2.18%), II B-3 10(2.72%), II C-125 (6.81%), II C-2 17(4.63%), II C-3 3(0.82%). Conclusions: MSCT is an effective technique to visualize and classify the coronary arteries in patients with D-TGA. And it is helpful for successful transfer of the coronary arteries and reducing the rate of coronary events after operation. (authors)