Imaging of the coronary venous system: validation of three-dimensional rotational venous angiography against dual-source computed tomography.
Information on the anatomy of the cardiac venous system (CVS) is increasingly important for cardiac resynchronization therapy or percutaneous transvenous mitral valve annuloplasty. Three-dimensional (3D) imaging can further improve the understanding of the relationship of cardiac structures. This study was performed to validate the accuracy of rotational coronary sinus angiography (CSA) displaying the 3D anatomy of the CVS compared to ECG-gated, contrast-enhanced, cardiac dual-source computed tomography (DSCT). Five domestic pigs (60 kg) underwent DSCT using a standardized examination protocol. Using a standard C-arm for fluoroscopy, a rotational CSA was obtained and 3D-image reconstructions performed. Side branches were identified using both methods and enumerated. Vessel visibility was estimated for each side branch and great cardiac vein/anterior interventricular vein. Also, vessel diameters were measured at distinct landmarks, i.e., side branching. The amount of contrast medium was determined and the effective radiation exposure of both methods was calculated. There was no significant difference regarding the vessel diameter of the great cardiac vein/anterior interventricular vein or its side branches. Also, estimation of vessel visibility was not different between the two imaging modalities. Estimated radiation exposure and amount of contrast medium were lower for rotational CSA. In conclusion, a 3D reconstruction of rotational CSA images is possible. All parts of the CVS are well depicted, allowing a 3D overview of the CVS anatomy. On-site 3D visualization might improve decision making during cardiac interventions. In contrast to DSCT, rotational CSA does not demonstrate the anatomy of the mitral annulus or the course of the left circumflex artery.
Knackstedt
Christian
C
Department of Cardiology, Pulmonology and Vascular Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany. cknackstedt@ukaachen.de
Mühlenbruch
Georg
G
Mischke
Karl
K
Bruners
Philipp
P
Schimpf
Thomas
T
Frechen
Dirk
D
Schummers
Georg
G
Mahnken
Andreas H
AH
Günther
Rolf W
RW
Kelm
Malte
M
Schauerte
Patrick
P
D000465:Algorithms; D000818:Animals; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D054326:Coronary Sinus / Q000000981:diagnostic imaging*; D003331:Coronary Vessels; D021621:Imaging, Three-Dimensional; D011857:Radiographic Image Interpretation, Computer-Assisted; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media