Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

Abstract

The aim of this study is to depict anatomic characteristics of sinuatrial nodal artery (SANA) and atrioventricular nodal artery (AVNA) of the heart with multidetector computed tomography. In our study, 400 patients referred to radiology departments of two institutions for coronary CT angiography were retrospectively evaluated. 350 patients had been examined by dual-source 64-slice CT, and 50 patients by 64-section multidetector CT. Transverse sections with a thickness of 0.6 mm were used in dual-source 64-slice CT studies, and 0.8 mm were used in 64-section multidetector CT examinations for the evaluation of coronary arteries and conduction system branches. Anatomic origin, localization of the origin, diameter, number, course, and variants of the SANA and AVNA were examined with coronary multidetector CT angiography. SANA and AVNA could be imaged by multidetector CT in all patients. There was a single SANA in 383 (95.7%) patients, and two SANAs in 17 (4.2%) patients. Two hundred thirty-three (58.2%) patients had one SANA originating from right coronary artery (RCA), 149 (37.2%) patients had one SANA originating from left circumflex (LCX) artery, and one patient had a SANA originating from the aorta. AVNA originated from distal RCA in 351 patients (87.7% of all patients), and from distal LCX artery in 49 patients (12.3% of all patients). The arteries that supply the sinuatrial node and atrioventricular node can be imaged with multidetector CT. These arteries have variations in number, origin and course.