case_images: PMC10860516_01
case_images: PMC10860516_02
case_images: Selected axial images of the contrast-enhanced CTCA acquired in the first episode (A-C) and the second episode (D-F). (A) Axial image during arterial phase in the first baseline CTCA showing only partial opacification in the most proximally located giant aneurysms in LCA (*) and RCA ( ). (B) Axial image from the same scan at a more inferior level showing non-opacification of a mid-RCA aneurysm ( ). (C) Venous phase axial image acquired in the first baseline CTCA at the same level as that shown in (A), showing giant aneurysms with suboptimal enhancement. (D-F) After optimization, axial images acquired in the second scan show better contrast enhancement, hence visualisation of the course of the LAD distal to the giant aneurysm (D, E) and multiple aneurysms are identified, including a previously undetected small aneurysm at mid LAD (E, arrow). Abbreviations: RCA = right coronary artery; LAD = left anterior descending artery.
case_images: uaad008f1.jpg
case_images: PMC10860516_02_uaad008f1.jpg
case_images: uaad008-F1
case_images: The initial acquired images were suboptimal with only the more proximal CAAs partially opacified with layering of contrast within, despite homogenous arterial enhancement in the aorta (Figure 1A and B). Though the more distal CAAs could then be identified, they were not captured with optimal enhancement (Figure 1C). The course of the LAD distal to the giant aneurysm could now be delineated (Figure 1D-F).
case_images: Contrast-enhanced retrospectively ECG-gated dual-source coronary CT angiography in a 30-month-old boy with history of Kawasaki disease in infancy. Curved multiplanar reformation of the (A) RCA, (B) LAD, and (C) LCx demonstrates multiple saccular aneurysms (*). Four of the RCA aneurysms in (A) meet the criteria for giant CAA. Along the LCA (B), there is a giant aneurysm involving distal LM and proximal LAD and a mild aneurysm in mid LAD. The origin of LCx (C) is involved by a giant aneurysm. (D) Three-dimensional volume rendering shows multiple giant CAAs. Abbreviations: RCA = right coronary artery; LAD = left anterior descending artery; LCx = left circumflex coronary artery.
case_images: uaad008f2.jpg
case_images: PMC10860516_02_uaad008f2.jpg
case_images: uaad008-F2