Myocardial Bridging: Depiction Rate and Morphology at CT Coronary Angiography—Comparison with Conventional Coronary Angiography

Leschka, Sebastian; Koepfli, Pascal; Husmann, Lars; Plass, André; Vachenauer, Robert; Gaemperli, Oliver; Schepis, Tiziano; Genoni, Michele; Marinček, Borut; Eberli, Franz R.; Kaufmann, Philipp A.; Alkadhi, Hatem

doi:10.1148/radiol.2463062071

Cited by 91 publications

(103 citation statements)

References 25 publications

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“…Myocardial bridging is defined as a segment of a major epicardial coronary artery running intramurally through the myocardium beneath a muscle bridge [64]. Although myocardial bridging is considered as a common, benign condition, complications, including transient ischemia and sudden death, have been repetitively described in the literature [65].…”

Section: Acute Aortic Dissectionmentioning

confidence: 99%

“…One of the most recent CT types, dual-source CT (DSCT), maintains the high spatial resolution of previous single-source 64-slice CT systems while enabling ECGgated imaging with an increased temporal resolution [13]. A number of studies have shown robust and auspicious results of DSCT coronary angiography regarding image quality [14,15] and accuracy [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Triple rule-out CT in the emergency department: protocols and spectrum of imaging findings

et al. 2008

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Triage decisions in patients suffering from acute chest pain remain a challenge. The patient's history, initial cardiac enzyme levels, or initial electrocardiograms (ECG) often do not allow selecting the patients in whom further tests are needed. Numerous vascular and non-vascular chest problems, such as pulmonary embolism (PE), aortic dissection, or acute coronary syndrome, as well as pulmonary, pleural, or osseous lesions, must be taken into account. Nowadays, contrast-enhanced multi-detector-row computed tomography (CT) has replaced previous invasive diagnostic procedures and currently represents the imaging modality of choice when the clinical suspicion of PE or acute aortic syndrome is raised. At the same time, CT is capable of detecting a multitude of non-vascular causes of acute chest pain, such as pneumonia, pericarditis, or fractures. Recent technical advances in CT technology have also shown great advantages for non-invasive imaging of the coronary arteries. In patients with acute chest pain, the optimization of triage decisions and cost-effectiveness using cardiac CT in the emergency department have been repetitively demonstrated. Triple rule-out CT denominates an ECG-gated protocol that allows for the depiction of the pulmonary arteries, thoracic aorta, and coronary arteries within a single examination. This can be accomplished through the use of a dedicated contrast media administration regimen resulting in a simultaneous attenuation of the three vessel territories. This review is intended to demonstrate CT parameters and contrast media administration protocols for performing a triple rule-out CT and discusses radiation dose issues pertinent to the protocol. Typical life-threatening and non-life-threatening diseases causing acute chest pain are illustrated. Triple rule-out CT in the emergency department: protocols and spectrum of imaging findings Abstract Triage decisions in patients suffering from acute chest pain remain a challenge. The patient's history, initial cardiac enzyme levels, or initial electrocardiograms (ECG) often do not allow selecting the patients in whom further tests are needed. Numerous vascular and non-vascular chest problems, such as pulmonary embolism (PE), aortic dissection, or acute coronary syndrome, as well as pulmonary, pleural, or osseous lesions, must be taken into account. Nowadays, contrast-enhanced multidetector-row computed tomography (CT) has replaced previous invasive diagnostic procedures and currently represents the imaging modality of choice when the clinical suspicion of PE or acute aortic syndrome is raised. At the same time, CT is capable of detecting a multitude of non-vascular causes of acute chest pain, such as pneumonia, pericarditis, or fractures. Recent technical advances in CT technology have also shown great advantages for non-invasive imaging of the coronary arteries. In patients with acute chest pain, the optimization of triage decisions and cost-effectiveness using cardiac CT in the emergency department have been repetitively demonstrated....

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Section: Acute Aortic Dissectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Triple rule-out CT in the emergency department: protocols and spectrum of imaging findings

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…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].…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Cta Image Reconstruction and Analysismentioning

confidence: 99%

“…It is of clinical importance to non-invasively differentiate compression-related and non-compression related MB by coronary CTA to determine proper treatment strategies. Traditional morphological parameters measured on coronary CTA have been studied, such as MB length and depth, but the value of any single parameter for predicting significant dynamic compression remains unclear [12,13]. Myocardial ischemia caused by MB is not only related to systolic vascular compression but also to persistent diastolic filling dysfunction [17].…”

Section: Cta Image Reconstruction and Analysismentioning

confidence: 99%

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

et al. 2018

Cardiovasc Imaging Asia

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Cardiac CT and MR for the Evaluation of Acute Chest Pain in the Emergency Setting

Verma

Mohammed

White

2019

Cardiac CT, PET &Amp; MR

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Myocardial Bridging: Depiction Rate and Morphology at CT Coronary Angiography—Comparison with Conventional Coronary Angiography

Abstract: The depiction rate of MB is greater with 64-section CT coronary angiography than with conventional coronary angiography. The degree of systolic compression of MB significantly correlates with tunneled segment depth but not length.

Cited by 91 publications

References 25 publications

Triple rule-out CT in the emergency department: protocols and spectrum of imaging findings

Triple rule-out CT in the emergency department: protocols and spectrum of imaging findings

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

Cardiac CT and MR for the Evaluation of Acute Chest Pain in the Emergency Setting

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