Myocardial bridging as evaluated by 16 row MDCT.
OBJECTIVE
The purpose of this study is to find out the prevalence, appearance and clinical symptoms of myocardial bridging (MB) by MDCT coronary angiography (CTA).


METHODS
A total of 280 (50 females) consecutive patients followed with coronary artery disease or postoperative stent and bypass control, underwent CTA performed by 16-MDCT scanner between January 2006 and April 2006. Short axis multiplanar reformatted images were evaluated. MBs were classified as complete and incomplete bridges with respect to continuity of the myocardium over the tunneled segment of left anterior descending artery (LAD) in interventricular groove and the cut-off value is 1.3mm. Patients diagnosed with MB on CTA who had prior catheter angiography studies were re-evaluated for the presence of MB.


RESULTS
One hundred and twenty MBs [98 (81.6%) on LAD, 2 (1.6%) on diagonal branch, 11 (9.1%) on obtuse marginal, 4 (3.3%) on right coronary artery, 5 (4.1%) on ramus intermedius artery] were detected in 108 (38.5%) patients. Eighty-five (70.8%) of bridged segments in 79 (28.2%) patients were complete and the rest [35 (29.2%) in 34 (12.1%) patients] were incomplete. In 12 patients two MBs (either on different arteries or on the same artery) were detected. The length of bridged segments in patients with complete and incomplete MBs varied between 4-50.9mm (mean 18mm) and 4-37.3mm (mean 13.6mm), respectively, and the depth of myocardium over the artery ranged between 1-6.4mm (mean 2.3mm) and 1-1.2mm (mean 1mm), respectively. Thirty (27.7%) out of 108 patients, in whom MB was detected on CTA, were found to have correlative catheter angiography studies, retrospectively and MB was detected only in 4 (13.3%) out of 30 patients.


CONCLUSIONS
MDCT coronary angiography is a non-invasive, efficient method in the diagnosis of MB avoiding the procedural risks that catheter angiography carries. MDCT coronary angiography allows direct visualization of the bridge itself and may thus give the opportunity to differentiate between complete and incomplete myocardial bridges.
Canyigit
Murat
M
Hacettepe University, Faculty of Medicine, Department of Radiology, Sihhiye, 06100 Ankara, Turkey. mcanyigit@yahoo.com
Hazirolan
Tuncay
T
Karcaaltincaba
Musturay
M
Dagoglu
Merve Gulbiz
MG
Akata
Deniz
D
Aytemir
Kudret
K
Oto
Ali
A
Balkanci
Ferhun
F
Akpinar
Erhan
E
Besim
Aytekin
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054084:Myocardial Bridging / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult