Detection of Myocardial Bridging with ECG-Gated MDCT and Multiplanar Reconstruction

Kantarcı, Mecit; Duran, Cihan; Durur, Irmak; Alper, Fatih; Önbaş, Ömer; Gülbaran, Murat; Okur, Aylin

doi:10.2214/ajr.05.0307

Cited by 73 publications

(83 citation statements)

References 24 publications

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“…The reason for generally higher prevalence of bridging detected by CT angiography compared with conventional catheter angiography lies in the nature and capabilities of the CT technique, as CT angiography examination can easily identify bridging, regardless of the shortness of the segment it involves, its superficiality, and presence of luminal narrowing. However, data from this series still shows higher prevalence of bridging among double LAD cases than the prevalence for general population obtained from previous CT angiography series (11,12).…”

Section: Discussioncontrasting

confidence: 68%

“…Data emerging from our series show definitely higher prevalence of these two anatomic variations among dual LAD cases compared with the previously described frequency for normal population (15%-30% for ramus intermedius and 3.5%-26% for bridging) (9)(10)(11)(12). The reason for generally higher prevalence of bridging detected by CT angiography compared with conventional catheter angiography lies in the nature and capabilities of the CT technique, as CT angiography examination can easily identify bridging, regardless of the shortness of the segment it involves, its superficiality, and presence of luminal narrowing.…”

Section: Discussionsupporting

confidence: 45%

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Prevalence of dual left anterior descending artery variations in CT angiography

Bozlar

Mş²,

Sarı³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to evaluate the frequency and features of dual left anterior descending artery (LAD) variants using computed tomography (CT) angiography. METHODSA total of 1337 consecutive coronary CT angiography examinations performed between April 2010 and December 2013 were retrospectively evaluated for the presence of dual LAD. CT examinations were performed with either 64-or 320-row multidetector CT scanners. All CT angiography images were evaluated for the presence and morphologic features of dual LAD subtypes. RESULTSFifty-six dual LAD variations (4%) were identified in this study population. Type 1 was the most common type of dual LAD (n=48), while Type 3 (n=3) and Type 4 (n=2) were infrequent and Type 2 was not detected. Additionally, we detected previously unclassified dual LAD variations in three cases. CONCLUSIONDual LAD may be a relatively more common variant than described in the medical literature, which is mostly based on catheter angiography studies. Coronary CT angiography seems markedly efficacious for detecting and documenting the anatomical details of dual LAD subtypes, as well as showing other associated cardiocoronary anomalies. Dual left anterior descending (LAD) coronary artery is a rare congenital anomaly (1), basically defined as the existence of two distinct segments of the vessel occupying the anterior interventricular sulcus (AIS) of the heart.First study classifying dual LAD anomalies based on coronary catheter angiography was published in 1983 by Spindola-Franco et al. (2), which has served as a primary classification system. However, individual reports further described previously unclassified LAD variants (3, 4). Most of the recent publications about dual LAD anomalies involve case reports and there is a paucity of large series using coronary computed tomography (CT) angiography (3-8).At present, quite a large number of coronary CT angiography examinations are being performed and recognition of dual LAD variations by CT angiography requires familiarity. Being aware of dual LAD anomalies could be critical for coronary bypass surgery and interventions. Surely, sound knowledge on dual LAD anomalies is a prerequisite for proper management of patients with coronary artery disease.In this study, we aimed to identify the frequency of dual LAD variations, and define the morphoanatomical features based on Spindola-Franco classification, using CT angiography. Appendageal subtypes of this variation were also documented and discussed. Methods PatientsThe study was approved by our institutional review board. A total of 1337 consecutive coronary CT angiography examinations performed in our department from April 2010 to December 2013 were retrospectively evaluated for dual LAD anomalies. These examinations had been performed for various reasons including, but not limited to, the assessment of coronary and cardiac morphology, electrocardiography (ECG) abnormalities, coronary bypass graft evaluation, coronary stent evaluation, coronary atherosclerosis evaluation and screening fo...

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionsupporting

confidence: 45%

Prevalence of dual left anterior descending artery variations in CT angiography

Bozlar

Mş²,

Sarı³

et al. 2015

Diagn Interv Radiol

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“…It is also called a tunneled artery (28). Myocardial bridging may cause clinical symptoms including angina, myocardial infarction, life-threatening arrhythmias, and sudden death (28,29). Ferreira et al (30) categorized myocardial bridging as either superficial (75% of cases) or deep (25% of cases).…”

Section: Myocardial Bridgingmentioning

confidence: 99%

“…Normally, the majority of myocardial blood flow is in diastole, and thus, systolic compression of the tunneled segment (i.e., superficial bridging) alone cannot sufficiently explain ischemia and its associated symptoms. However, deep myocardial bridging could compromise coronary diastolic The diagnosis of bridging with CCA can be challenging because the interpretation of catheter angiography findings requires an experienced eye, and only deep bridges can be detected with CCA (29,33,34).…”

Section: Myocardial Bridgingmentioning

confidence: 99%

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

Kantarcı

Doğanay

Karçaaltıncaba

et al. 2011

Diagn Interv Radiol

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261C oronary artery disease is responsible for millions of deaths per year in developed countries (1, 2). Early recognition of coronary artery disease is important for the prevention of its related complications and improving prognosis (3). Catheter angiography has been considered the gold standard imaging method for evaluating the coronary tree. The major advantages of conventional coronary angiography (CCA) are its high spatial and temporal resolutions and the option of directly performing interventions, such as balloon dilation or coronary stent placement (4). However, CCA is an invasive procedure that carries the risk of morbidity and mortality (3). In addition, CCA provides only luminal data and is limited in revealing changes in the vessel wall and the adjacent soft tissues. Conversely, multidetector computed tomography coronary angiography (MDCT-CA) not only provides visualization of the vessel lumen but also displays the vessel wall and surrounding soft tissues, allowing for the detection of various congenital or acquired abnormalities of the coronary arteries that may not be evident with CCA (3).In this article, on the basis of our experience with more than 15 000 MDCT-CA from seven different centers, we reviewed clinical conditions in which MDCT-CA may be more helpful compared with CCA. Coronary CT techniqueWith the advent of technological refinements in the last decade, MDCT-CA has gained widespread use for the evaluation of coronary artery diseases. Currently, state-of-the-art computed tomography (CT) systems can simultaneously acquire 64 or more submillimeter sections with a gantry rotation time of less than half a second. Previous limitations of CT for evaluating the vascular system, associated with older generation scanners, have now been eliminated. Presently, a thinner section thickness allows for isotropic voxels, which is essential for optimum high-resolution, three-dimensional (3D) reconstruction and other postprocessing displays, such as maximum projection reformatting (MPR) in any selected plane. Faster scanners have resulted in shorter scans and shorter contrast bolus durations, allowing for the use of less contrast agent at a higher flow rate to achieve greater luminal enhancement. Motion artifacts from breathing are no longer a problem since highresolution imaging of the entire heart can be obtained in a single breath hold. Electrocardiography (ECG) gating techniques improve temporal resolution and minimize imaging artifacts caused by cardiac motion. With more recent technological advances, a reduction in radiation dose, for example, by the utilization of prospective gating, has occurred without any deterioration in diagnostic image quality (5).In our centers, images were acquired using either 16-or 64-MDCT scanners. Eighty-five to one hundred milliliters of iodinated contrast medium (Ultravist 370, Schering, Berlin, Germany) was intravenously ABSTRACT In this review, we aimed to outline the clinical and pathological conditions for which multidetector computed tomography coronary angiogr...

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“…Usually, bridges are incidentally identified during diagnostic angiography or autopsy studies. In recent years, new invasive ultrasound-based modalities, such as intravascular ultrasound and intracoronary Doppler imaging (4,5), as well as noninvasive methods (eg, computed tomography, magnetic resonance imaging) (6) have been widely used in the diagnosis of myocardial bridges.…”

Section: Epidemiology Clinical Manifestation and Diagnosis Of Myocarmentioning

confidence: 99%

Myocardial bridges are free from atherosclerosis: Overview of the underlying mechanisms

Chatzizisis

Giannoglou

2009

Canadian Journal of Cardiology

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Detection of Myocardial Bridging with ECG-Gated MDCT and Multiplanar Reconstruction

Cited by 73 publications

References 24 publications

Prevalence of dual left anterior descending artery variations in CT angiography

Prevalence of dual left anterior descending artery variations in CT angiography

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

Myocardial bridges are free from atherosclerosis: Overview of the underlying mechanisms

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