Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

  • Hwang, Jin-Ho (Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Ko, Sung-Min (Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Roh, Hong-Gee (Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Song, Meong-Gun (Department of Thoracic Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Shin, Je-Kyoun (Department of Thoracic Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Chee, Hyun-Kun (Department of Thoracic Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Kim, Joon-Suk (Department of Thoracic Surgery, Konkuk University Hospital, Konkuk University School of Medicine)
  • Received : 2010.04.02
  • Accepted : 2010.05.26
  • Published : 2010.10.01
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Abstract

Objective: To evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT). Materials and Methods: CT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth (${\leq}$ 1 or < 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium. Results: Of the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was $16.4{\pm}8.6$ mm. The mean length and depth of a tunneled segment for deep MB were $27.6{\pm}12.8$ mm and $3.0{\pm}1.4$ mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%. Conclusion: The depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type.

Keywords

Acknowledgement

Supported by : Konkuk University Medical Center

References

  1. Mohlenkamp S, Hort W, Ge J, Erbel R. Update on myocardial bridging. Circulation 2002;106:2616-2622 https://doi.org/10.1161/01.CIR.0000038420.14867.7A
  2. Alegria JR, Herrmann J, Holmes DR Jr, Lerman A, Rihal CS. Myocardial bridging. Eur Heart J 2005;26:1159-1168 https://doi.org/10.1093/eurheartj/ehi203
  3. Kramer JR, Kitazume H, Proudfit WL, Sones FM Jr. Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery. Am Heart J 1982;103:283-288 https://doi.org/10.1016/0002-8703(82)90500-2
  4. Noble J, Bourassa MG, Petitclerc R, Dyrda I. Myocardial bridging and milking effect of the left anterior descending coronary artery: normal variant or obstruction? Am J Cardiol 1976;37:993-999 https://doi.org/10.1016/0002-9149(76)90414-8
  5. Rossi L, Dander B, Nidasio GP, Arbustini E, Paris B, Vassanelli C, et al. Myocardial bridges and ischemic heart disease. Eur Heart J 1980;1:239-245
  6. Bourassa MG, Butnaru A, Lesperance J, Tardif JC. Symptomatic myocardial bridges: overview of ischemic mechanisms and current diagnostic and treatment strategies. J Am Coll Cardiol 2003;41:351-359
  7. Amoroso G, Battolla L, Gemignani C, Panconi M, Petronio AS, Rondine P, et al. Myocardial bridging on left anterior descending coronary artery evaluated by multidetector computed tomography. Int J Cardiol 2004;95:335-337 https://doi.org/10.1016/j.ijcard.2003.05.047
  8. Goitein O, Lacomis JM. Myocardial bridging: noninvasive diagnosis with multidetector CT. J Comput Assist Tomogr 2005;29:238-240 https://doi.org/10.1097/01.rct.0000155061.73107.ca
  9. Ko SM, Kim KS. Multidetector-row CT coronary angiographic finding of myocardial bridging. Br J Radiol 2007;80:E196-E200 https://doi.org/10.1259/bjr/85712380
  10. Kantarci M, Duran C, Durur I, Alper F, Onbas O, Gulbaran M, et al. Detection of myocardial bridging with ECG-gated MDCT and multiplanar reconstruction. AJR Am J Roentgenol 2006;186:S391-S394 https://doi.org/10.2214/AJR.05.0307
  11. Zeina AR, Odeh M, Blinder J, Rosenschein U, Barmeir E. Myocardial bridge: evaluation on MDCT. AJR Am J Roentgenol 2007;188:1069-1073 https://doi.org/10.2214/AJR.06.0714
  12. Konen E, Goitein O, Sternik L, Eshet Y, Shemesh J, Di Segni E. The prevalence and anatomical patterns of intramuscular coronary arteries: a coronary computed tomography angiographic study. J Am Coll Cardiol 2007;49:587-593 https://doi.org/10.1016/j.jacc.2006.09.039
  13. Kawawa Y, Ishikawa Y, Gomi T, Nagamoto M, Terada H, Ishii T, et al. Detection of myocardial bridge and evaluation of its anatomical properties by coronary multislice spiral computed tomography. Eur J Radiol 2007;61:130-138 https://doi.org/10.1016/j.ejrad.2006.08.029
  14. Ko SM, Choi JS, Nam CW, Hur SH. Incidence and clinical significance of myocardial bridging with ECG-gated 16-row MDCT coronary angiography. Int J Cardiovasc Imaging 2008;24:445-452 https://doi.org/10.1007/s10554-007-9272-2
  15. Leschka S, Koepfli P, Husmann L, Plass A, Vachenauer R, Gaemperli O, et al. Myocardial bridging: depiction rate and morphology at CT coronary angiography--comparison with conventional coronary angiography. Radiology 2008;246:754-762 https://doi.org/10.1148/radiol.2463062071
  16. Hazirolan T, Canyigit M, Karcaaltincaba M, Dagoglu MG, Akata D, Aytemir K, et al. Myocardial bridging on MDCT. AJR Am J Roentgenol 2007;188:1074-1080 https://doi.org/10.2214/AJR.06.0417
  17. Konen E, Goitein O, Di Segni E. Myocardial bridging, a common anatomical variant rather than a congenital anomaly. Semin Ultrasound CT MRI 2008;29:195-203 https://doi.org/10.1053/j.sult.2008.02.005
  18. Jodocy D, Aglan I, Friedrich G, Mallouhi A, Pachinger O, Jaschke W, et al. Left anterior descending coronary artery myocardial bridging by multislice computed tomography: correlation with clinical findings. Eur J Radiol 2010;73:89-95 https://doi.org/10.1016/j.ejrad.2008.10.004
  19. Lu GM, Zhang LJ, Guo H, Huang W, Merges RD. Comparison of myocardial bridging by dual-source CT with conventional coronary angiography. Circ J 2008;72:1079-1085 https://doi.org/10.1253/circj.72.1079
  20. Kim PJ, Hur G, Kim SY, Namgung J, Hong SW, Kim YH, et al. Frequency of myocardial bridges and dynamic compression of epicardial coronary arteries: a comparison between computed tomography and invasive coronary angiography. Circulation 2009;119:1408-1416 https://doi.org/10.1161/CIRCULATIONAHA.108.788901
  21. Canyigit M, Hazirolan T, Karcaaltincaba M, Dagoglu MG, Akata D, Aytemir K, et al. Myocardial bridging as evaluated by 16 row MDCT. Eur J Radiol 2009;69:156-164 https://doi.org/10.1016/j.ejrad.2007.09.038
  22. Jacobs JE, Bod J, Kim DC, Hecht EM, Srichai MB. Myocardial bridging: evaluation using single- and dual-source multidetector cardiac computed tomographic angiography. J Comput Assist Tomogr 2008;32:242-246 https://doi.org/10.1097/RCT.0b013e318075e6c3
  23. La Grutta L, Runza G, Lo Re G, Galia M, Alaimo V, Grassedonio E, et al. Prevalence of myocardial bridging and correlation with coronary atherosclerosis studied with 64-slice CT coronary angiography. Radiol Med 2009;114:1024-1036 https://doi.org/10.1007/s11547-009-0446-y
  24. Lubarsky L, Gupta MP, Hecht HS. Evaluation of myocardial bridging of the left anterior descending coronary artery by 64-slice multidetector computed tomographic angiography. Am J Cardiol 2007;100:1081-1082 https://doi.org/10.1016/j.amjcard.2007.05.029
  25. Zhang LJ, Yang GF, Zhou CS, Huang W, Lu GM, Shiroishi MS. Multiphase evaluation of myocardial bridging with dual-source computed tomography. Acta Radiol 2009;50:775-780 https://doi.org/10.1080/02841850903049341
  26. Johansen C, Kirsch J, Araoz P, Williamson E. Detection of myocardial bridging by 64-row computed tomography angiography of the coronaries. J Comput Assist Tomogr 2008;32:448-451 https://doi.org/10.1097/RCT.0b013e3180cabbfd
  27. Chen YD, Wu MH, Sheu MH, Chang CY. Myocardial bridging in Taiwan: depiction by multidetector computed tomography coronary angiography. J Formos Med Assoc 2009;108:469-474 https://doi.org/10.1016/S0929-6646(09)60094-2
  28. Matt D, Scheffel H, Leschka S, Flohr TG, Marincek B, Kaufmann PA, et al. Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability. AJR Am J Roentgenol 2007;189:567-573 https://doi.org/10.2214/AJR.07.2078
  29. Blankstein R, Shturman LD, Rogers IS, Rocha-Filho JA, Okada DR, Sarwar A, et al. Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J Am Coll Cardiol 2009;54:1072-1084 https://doi.org/10.1016/j.jacc.2009.06.014
  30. Ko SM, Kim NR, Kim DH, Song MG, Kim JH. Assessment of image quality and radiation dose in prospective ECG-triggered coronary CT angiography compared with retrospective ECGgated coronary CT angiography. Int J Cardiovasc Imaging 2010;26:93-101 https://doi.org/10.1007/s10554-009-9554-y
  31. Baumuller S, Leschka S, Desbiolles L, Stolzmann P, Scheffel H, Seifert B, et al. Dual-source versus 64-section CT coronary angiography at lower heart rates: comparison of accuracy and radiation dose. Radiology 2009;253:56-64 https://doi.org/10.1148/radiol.2531090065
  32. Donnino R, Jacobs JE, Doshi JV, Hecht EM, Kim DC, Babb JS, et al. Dual-source versus single-source cardiac CT angiography: comparison of diagnostic image quality. AJR Am J Roentgenol 2009;192:1051-1056 https://doi.org/10.2214/AJR.08.1198
  33. Wang Y, Zhang Z, Kong L, Song L, Merges RD, Chen J, et al. Dual-source CT coronary angiography in patients with atrial fibrillation: comparison with single-source CT. Eur J Radiol 2008;68:434-441 https://doi.org/10.1016/j.ejrad.2008.09.011
  34. Meng L, Cui L, Cheng Y, Wu X, Tang Y, Wang Y, et al. Effect of heart rate and coronary calcification on the diagnostic accuracy of the dual-source CT coronary angiography in patients with suspected coronary artery disease. Korean J Radiol 2009;10:347-354 https://doi.org/10.3348/kjr.2009.10.4.347
  35. Brodoefel H, Burgstahler C, Tsiflikas I, Reimann A, Schroeder S, Claussen CD, et al. Dual-source CT: effect of heart rate, heart rate variability, and calcification on image quality and diagnostic accuracy. Radiology 2008;247:346-355 https://doi.org/10.1148/radiol.2472070906
  36. Bayrak F, Degertekin M, Eroglu E, Guneysu T, Sevinc D, Gemici G, et al. Evaluation of myocardial bridges with 64-slice computed tomography coronary angiography. Acta Cardiol 2009;64:341-346 https://doi.org/10.2143/AC.64.3.2038019
  37. Jeong YH, Kang MK, Park SR, Kang YR, Choi HC, Hwang SJ, et al. A head-to-head comparison between 64-slice multidetector computed tomographic and conventional coronary angiographies in measurement of myocardial bridge. Int J Cardiol 2009 [Epub ahead of print]
  38. Kim SY, Lee YS, Lee JB, Ryu JK, Choi JY, Chang SG, et al. Evaluation of myocardial bridge with multidetector computed tomography. Circ J 2010;74:137-141 https://doi.org/10.1253/circj.CJ-09-0407
  39. Atar E, Kornowski R, Fuchs S, Naftali N, Belenky A, Bachar GN. Prevalence of myocardial bridging detected with 64-slice multidetector coronary computed tomography angiography in asymptomatic adults. J Cardiovasc Comput Tomogr 2007;1:78-83 https://doi.org/10.1016/j.jcct.2007.08.003

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