Detection of myocardial bridge and evaluation of its anatomical properties by coronary multislice spiral computed tomography

Attenuation Drop of Intra-Mural Coronary Segment Observed at Diastolic Phase of Coronary CT Angiography Predicts Significant Systolic Compression of Myocardial Bridge

“…However, it is neither reasonable nor practical to use such an invasive imaging modality merely to quantify MB compression in patients without coronary artery disease. Coronary CTA has been proven to be more sensitive than ICA for detection of MB due to its ability to visualize the intra-mural course of coronary arteries [12][13][14][15][16]. However, determination of compression extent requires artifact-free images of end-systolic phases, which are sometimes not available with low-dose prospective acquisition [12].…”

“…MB lesions were divided into three subgroups according to the extent of systolic compression as determined by end-systolic phases of CTA imThe MB detection rate varies significantly between the different imaging modalities of coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA). Coronary CTA usually reveals a much higher incidence of MB than ICA [12][13][14][15][16] due to the capability of coronary CTA to detect MB without the presence of systolic compression. The clinical significance of myocardial bridging lies in related regional hemodynamic changes caused by dynamic compression.…”

Myocardial Bridge as a Structure of “Double-Edged Sword” for the Coronary Artery

“…With recent advances in imaging techniques such as MDCT and intravascular ultra sonography (IVUS), cardiologists have gradually been aware of MB in clinical practice through direct image capture. [14][15][16] The frequency of MB in the LAD of patients with coronary heart disease assessed by MDCT in Turkey, 16) Japan 17) and Israel 18) are 3.5%, 15.8% and 26%, respectively (Fig. 2), but remains lower than that found at autopsy.…”

“…5) Atherosclerosis suppression in the LAD beneath MB Clinical coronary angiography, IVUS and MDCT have shown the absence of atherosclerotic changes in the LAD intima beneath MB, whereas atherosclerotic changes are always found in the LAD segment proximal to an MB entrance in the various extent. 14,15,17,18,31) them, 172 (79.6%) had coronary heart diseases including angina, myocardial ischemia, myocardial infarction (MI), and sudden cardiac death ( Table 1). We assigned all of these patients to one group without considerable coronary atherosclerosis that develops around middle age and another with coronary atherosclerosis that is probably exacerbated by MB mainly in older persons.…”

“…However, the frequency of MB >1 mm thick determined by MDCT in Japan approximates that of a similar thickness determined by autopsy in Japan, which is 15.8% vs. 13.3%. 17) Detecting MB with MDCT is thus an effi cient way to objectively demonstrate MB in vivo. Furthermore, the recent development of 64-row MDCT has increased the frequency of MB detection to 32% in the US 19) and 58% in Korea.…”