Figure 3

Whole heart coronary magnetic resonance angiography (MRA) at 1×1×1 mm resolution with multiplanar maximum intensity projection reformats to demonstrate the coronary arteries. (A) The right coronary artery (RCA) is seen to have a normal origin and course. (B) Excellent image quality is evident from the depiction of a small RCA marginal branch (arrow). (C) A large conal branch (arrows) takes a pre-pulmonic course and anastomoses with the left coronary system at the apex. (D, E) The left anterior descending (D solid arrow) and left circumflex (D dotted arrow) coronary arteries are shown in their proximal portions. Although the bifurcation of these vessels is clearly depicted, note that the left main coronary artery is not visible and that there is a’gap’ between the aortic root and the LAD/Cx bifurcation even on ultrahigh resolution (0.5 × 0.5 × 0.5 mm) MRA (E arrows). This was misinterpreted as an occlusion of the left main segment as the diagnosis of single coronary artery had not been recognized. RV = right ventricle; LV = left ventricle; nAo = neo-aorta; RA = right atrium; LA = left atrium.