Objective    To summarize the multislice spiral CT findings in congenital abnormal coronary artery origin and its clinical significance.     Methods    Imaging and clinical data about coronary artery angiography for 4 581 patients were collected. Abnormal coronary artery origin was found in 41 patients (34 males

7 females) at the age of 3-81 (54.3±15.6). Their axial thin reconstruction images were observed followed by multi-planar reconstruction (MPR)

maximum intensity project (MIP) and volume rendering (VR)  to demonstrate the origin and course of coronary arteries.     Results    Abnormal coronary artery origin was found in 41 patients with an incidence of 0.9%. Among the 41 patients

the right coronary artery (RCA) was originated from the left coronary sinus in 9

high orifice in right coronary sinus was found in 6

the left coronary artery was originated from the right coronary sinus in 3

high orifice in left coronary artery (LCA) was observed in 4

the left anterior descending artery (LAD) and left circumflex (LCX) were originated from the left coronary sinus in 8

the LAD was originated from the RCA in 2

the LCX was originated from the RCA in 5

the RCA and LCA were originated from a common trunk in 4

respectively. Of the 41 patients

23 had seizures of dyspnea and palpitation

4 had angina including 2 who had cardiogenic shock.     Conclusion    Abnormal coronary artery origins and courses can be demonstrated at multislice  spiral CT angiography which should therefore be considered a prime non-invasive imaging tool for suspected abnormal coronary artery origins.