PURPOSE: This paper aims to provide the tools for a complete anatomical evaluation of the coronary tree using 64-slice computed tomography (CT) and evaluate the prevalence of anatomical variants and anomalies in a population of 202 consecutive patients. MATERIALS AND METHODS: Two hundred and two patients with suspected coronary artery disease underwent 64-slice CT with a standard protocol. Two observers working in consensus evaluated and collected the data regarding anatomical variants and anomalies of the coronary vessels. RESULTS: In the 202 consecutive patients, the prevalence of anatomical variants was: left dominant circulation (7%), absent left main (5%), presence of intermediate branch (17%), aortic origin of conus branch (13%) and circumflex origin of sinus node branch (15%). Coronary anomalies (origin and course, intrinsic and termination) showed an overall prevalence of 25%. CONCLUSIONS: CT is the ideal method for the three-dimensional evaluation of the coronary tree. Anatomical variants and anomalies of the coronary arteries are quite common and should be known and recognised promptly by the operators.
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