Comparison of myocardial bridging by dual-source CT with conventional coronary angiography.
BACKGROUND
The diagnosis of myocardial bridging (MB) is of clinical importance because of the association between MB and compromised coronary flow. The aim of this study was to compare the ability of dual-source computed tomography (DSCT) and conventional coronary angiography (CAG) to detect MB.


RESULTS
DSCT were performed in 53 patients and 4-dimensional (D) reconstruction was subsequently performed in 16 patients with MB for double-blinded comparison with the findings of CAG. The diameters at systole and diastole of the coronary segments proximal and distal to the MB and of the tunneled segment were measured. The relationship between the rate of stenosis of the tunneled artery and the "milking" effect on 4-D reconstruction was analyzed. Of the 53 patients, CAG and DSCT detected 4 MBs in 3 patients and 21 MBs in 16 patients, respectively (p<0.001). On a per-patient and per-MB basis, significant difference was found between both methods (p=0.001, p<0.001). The 4-D reconstruction showed the milking effect and abnormal blood flow, detecting more MBs than did CAG (p<0.001). The rate of stenosis of the tunneled artery was related to the milking effect on the 4-D reconstruction (r=0.640, p=0.006).


CONCLUSIONS
In the present study, DSCT detected more MBs than CAG, suggesting its clinical application for diagnosis of this condition.
Lu
Guang-Ming
GM
Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nangjing, Jiangsu Province 200012, China. guangminglu66@yahoo.com.cn
Zhang
Long-Jiang
LJ
Guo
Hua
H
Huang
Wei
W
Merges
Reto D
RD
D000368:Aged; D017023:Coronary Angiography / Q000379:methods* / Q000592:standards*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards*