Clinical value of the correlations of mural coronary artery compression extent with myocardial bridge length and thickness evaluated by 128-slice CT

Abstract

This study aimed to investigate the correlations between the detection rate of mural coronary artery (MCA) by 128-slice CT and the MCA compression extent in systole with myocardial bridge (MB) length and thickness. A retrospective analysis was conducted for 580 patients receiving multislicespiral CT coronary angiography (MSCTCA). In addition, the MCA incidence rate and position were detected, and the MB length and thickness in the left anterior descending branch (LAD) and MCA compression extent in systole were measured to compare the differences between MB-MCA length and thickness among the mild, moderate and severe groups. A total of 140 cases of MB-MCA (24.14%) were involved in the study. Among them, 104 cases occurred in the middle segment of the LAD (74.3%), 16 cases (11.4%) occurred in the distal segment of the LAD, 8 cases (5.7%) occurred in the left circumflex-obtuse marginal branch (LCX-OM), 7 cases (5.0%) occurred in the first diagonal branch (1st D), 3 cases (2.1%) in the intermediate branch (M) and 2 cases (1.5%) occurred in the posterior descending branch of the right coronary artery (RCA-PD). The mean length of the MB in the LAD was 21.80±5.98 mm, the mean thickness was 2.15±0.74 mm and the mean compression extent was 38.5±19.6%. Among the different groups, there were no significant difference in MB length (P>0.05) but there were significant differences in MB thickness (P<0.05). In addition, the extent of MCA compression in systole was linearly and positively correlated with MB thickness (r=0.408, P<0.05) but was not correlated with MB length (r=0.076, P>0.05). 128-slice CT coronary angiography (SCTCA) is able to accurately detect MB-MCA and evaluate the correlations of MCA compression extent in systole with MB length and thickness which provides a basis for its clinical use.

Histological Characteristics of Myocardial Bridge With an Ultrasonic Echolucent Band

“…Of note, however, a recent clinical study demonstrated a linear and positive correlation between the thickness of MBs and arterial compression as assessed on multi-detector computed tomography. 13 In conclusion, the present investigation suggests that the characteristic halo on the IVUS image of MB corresponds to muscle tissue overlying the coronary artery. Precise IVUS observations of morphologic MB properties may facilitate the accurate diagnosis of MB, providing unique pathophysiologic insights into this common anomaly as well as essential clinical information in determining the optimal treatment strategy for the patients with MB.…”

Systolic Compression of a Myocardial Bridged Coronary Artery and its Morphologic Characteristics: A Combination Study of Computed Tomography Angiography and Invasive Angiography

“…In the study conducted by Niu et al (4), using a 128-slice CT scanner, the degree of systolic compression was calculated by the cross-sectional area method, in which the vascular area of the MB-MCA (myocardial bridge-mural coronary artery) in systole was subtracted from that during diastole, divided by the vascular area of the MB-MCA during diastole. Moreover, Liu et al, using a dual-source CT scanner, calculated the degree of the MB-MCA compression as: [(end diastolic diameter-end systolic diameter)/end diastolic diameter] × 100% (6).…”

“…In addition, long term compression on the MB-MCA during systole leads to endothelial vessel injuries resulting from high shear stress, while the increased pressure and vortex generation in the proximal MB segment results in atherosclerosis. Moreover, in the case of deep MB, the blood perfusion is decreased in both systole and early and mid-diastole (4). …”

“…The effectiveness of coronary computed tomographic angiography (CCTA) in the detection of MB and its morphological features has been shown in several prior studies (2, 4-9). However, the clinical importance of the MB segment cannot be justified merely by the systolic compression of the involved segment, the role of the depth and length of the MB segment on the clinical presentation cannot be ignored (2).…”

“…However, the clinical importance of the MB segment cannot be justified merely by the systolic compression of the involved segment, the role of the depth and length of the MB segment on the clinical presentation cannot be ignored (2). The correlation between the MB length and depth and luminal narrowing of the tunneled segment has been previously investigated (4, 6-10). In all of these studies, the correlation was investigated by CCTA; however, in those cases of the concomitant use of invasive coronary angiography (ICA), the overall accuracy of both methods were compared with each other.…”