[Regional myocardial perfusion abnormality detected by digital subtraction angiography in a case of XXXX with coronary arterial fistulae].

@entity1 @entity662 @entity296 @entity5988 @entity2461 @entity509 @entity6128 @entity1897 @entity292 @entity741
A 19-year-old @entity1 with @entity2461 and increasingly severe @entity662 received various examinations including exercise stress radionuclide test, which revealed hypokinesis and @entity296 in the apex and @entity5988 . Conventional selective coronary arteriography and newly-developed ECG synchronized digital subtraction angiography (DSA) were performed to identify the genesis of her @entity741 . Selective coronary arteriography revealed congenital coronary arterial fistulae in the right and left coronary arteries. The largest @entity292 was observed around the obtuse marginal artery terminating in the left ventricle. Although stenosis of the left circumflex and @entity6128 ( @entity6128 ) were not observed, the @entity6128 appeared to be hypoplastic. @entity509 of the @entity6128 and the steal phenomenon by arterial @entity292 could have been responsible for the @entity741 in the apex, but this method did not clearly reveal the area and the degree of @entity741 in the apex. Sequentially subtracted images during the arterial and capillary phases were obtained by utilizing ECG-synchronized DSA for selective coronary arteriography. For these images, densitometric analysis was adapted to the myocardial region, i.e. circumferential densitometry using 21 segments around the left ventricular wall. @entity296 was clearly demonstrated in the apex in capillary phase images. Moreover, circumferential analysis provided detailed information about the area and the degree of @entity1897 in the myocardium. This analysis by DSA may prove useful for evaluating myocardial perfusion abnormalities.
