Coronary anomalies comprise a diverse group of malformations, some of them asymptomatic with a benign course, and the others related to symptoms as chest pain and sudden death. Such anomalies may be classified as follows: 1) anomalies of origination and course; 2) anomalies of intrinsic coronary arterial anatomy; 3) anomalies of coronary termination. The origin and the proximal course of anomalous coronary arteries are the main prognostic factors, and interarterial course or a coronary artery is considered to be malignant due its association with increased risk of sudden death. Coronary computed tomography angiography has become the reference method for such an assessment as it detects not only anomalies in origination of these arteries, but also its course in relation to other mediastinal structures, which plays a relevant role in the definition of the therapeutic management. Finally, it is essential for radiologists to recognize and characterize such anomalies.

Keywords: Coronary anomaly; Coronary computed tomography angiography; Coronary angiography.

The coronary artery calcium score plays an Important role In cardiovascular risk stratification, showing a significant association with the medium- or long-term occurrence of major cardiovascular events. Here, we discuss the following: protocols for the acquisition and quantification of the coronary artery calcium score by multidetector computed tomography; the role of the coronary artery calcium score in coronary risk stratification and its comparison with other clinical scores; its indications, interpretation, and prognosis in asymptomatic patients; and its use in patients who are symptomatic or have diabetes.

Keywords: Calcinosis/diagnosis; Cardiomyopathies/diagnosis; Tomography, X-ray computed; Cardiovascular diseases/epidemiology; Coronary artery disease/epidemiology.

Magnetic resonance imaging (MRI) is the gold-standard imaging modality for evaluating perianal fistulas, playing a pivotal role in characterizing fistula anatomy and guiding optimal surgical strategies. Appropriate preoperative MRI assessment can significantly reduce recurrence rates and minimize the risk of complications, such as fecal incontinence. This article reviews the most relevant information that an MRI report should contain to aid effective surgical decision-making for perianal fistulas. These features influence therapeutic choices, including decisions regarding the suitability of techniques like fistulotomy, ligation of the intersphincteric fistula tract (LIFT), video-assisted anal fistula treatment (VAAFT), fistula-tract laser closure (FiLaC), and advancement flaps. The emerging role of three-dimensional (3D) modeling from MRI data is also discussed, highlighting its potential to enhance surgeons’ spatial understanding of complex fistulous anatomy, thereby improving surgical planning, reducing operative time, and ultimately improving outcomes. However, the generation of accurate 3D models depends on meticulous image segmentation and interpretation by experienced radiologists. Future research directions, including the integration of 3D models with intraoperative navigation and standardized assessment of inflammatory activity, are also addressed in this review.

Keywords: Rectal fistula/diagnostic imaging; Anal canal/surgery; Magnetic resonance imaging; Imaging, three-dimensional; Colorectal surgery.