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. 2008 Jul 20;9(Suppl):S1–S6. doi: 10.3348/kjr.2008.9.s.s1

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Copyright © 2008 The Korean Radiological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 2 — Coronary sinus anomaly with stenosis of right atrial ostium and coexisting levoatriocardinal vein communication to left atrium in 64-year-old woman.

A. Dorsal view of reconstructed volume-rendered image reveals abnormal engorged coronary sinus (long white arrow) without grossly visible communication with right atrium (RA). There was engorged vascular channel (black star) arising from coronary sinus that was highly suggestive of communication with left atrium (LA).

B. Maximum-intensity-projection image revealed that aforementioned vascular channel (black star) was connected to left atrium (LA) with large opening. Evidence of large left-to-right shunting is also noted according to equal high-contrast density within CS and LA. Stenostic end of coronary sinus into right atrium (RA) was also seen (black arrow).

C. Sequential maximum-intensity-projection image next to B demonstrates stenostic right atrial ostium (black arrow) of coronary sinus. RA = right atrium, LA = left atrium

D-G. Illustration of enlargement of coronary sinus (CS) associated with (D) a persistent left superior vena cava (PLSVC); (E) PLSVC and other anomalous systemic venous return; (F) anomalous left-to-right shunt from left atrium; (G) unusually large communication between left atrium and coronary sinus (modified from Mantini and colleagues (1)).

H. Illustration of absence of coronary sinus, which is always associated with persistent left superior vena cava (PLSVC) and atrial septal defect (modified from Mantini and colleagues (1)).

I. Illustration of hypoplasic coronary sinus; cardiac veins failed to join coronary sinus and emptied into atrial chamber through dilated thebesian channels (modified from Mantini and colleagues (1)).

J. With functional persistent left superior vena cava (PLSVC), blood returns in retrograde direction, passing upward to persistent left superior vena cava (PLSVC), left innominate vein, right superior vena cava, and eventually into right atrium.

K. Without persistent left superior vena cava (PLSVC), blood returns through levoatriocardinal vein then into left atrium (modified from Mantini and colleagues (1)).