CTICasesMisregistration Artifact mimicking Anomalous Right Coronary Artery
Imaging findings
Coronary CT angiography in a patient with chest pain suggests an anomalous origin of the right coronary artery from the pulmonary artery (RCAPA). A catheter angiogram and review of the aortic root on lung windows demonstrate a cardiac motion misregistration artifact due to an irregular heartbeat.
Key takeaways
Cardiac motion and misregistration artifacts can create a false appearance of anomalous coronary origin (such as RCAPA or ALCAPA) on coronary CTA. Astute review of the raw data, looking for slice-to-slice displacement or lung window misregistration, is crucial.
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