title: Imaging of the coronary venous system in patients with congestive heart failure: comparison of 16 slice MSCT and retrograde coronary sinus venography: comparative imaging of coronary venous system.
abstract: BACKGROUND
  Knowledge of the anatomy of the coronary venous system (CVS) is important for planning of cardiac interventions like cardiac resynchronization therapy or percutaneus mitral annuloplasty. Different methods have been used for preprocedural visualization of the CVS. However, limited data is available comparing invasive retrograde coronary sinus angiography (CSA) and non-invasive multi slice computed tomography (MSCT). Thus, a comparison of retrograde CSA and ECG-gated MSCT for the visualization of the CVS in patients with congestive heart failure (CHF) was performed.
  
  
  METHODS
  20 patients (male: 11) with CHF underwent CSA and MSCT (16 x 0.75 mm collimation, tube voltage: 120 kV, tube current: 550 mAs(eff)). Both methods were compared with respect to vessel diameter and visibility.
  
  
  RESULTS
  Vessel visualization was better using retrograde CSA except for middle cardiac vein and small veins which were better seen with MSCT. Overall, there was a trend that MSCT detected more vessels. Vessel diameters were larger measured using retrograde CSA, but only statistically significant for the coronary sinus and middle cardiac vein.
  
  
  CONCLUSIONS
  Whereas MSCT is more suitable for an overview, retrograde CSA offers a more detailed visualization of the CVS including marginal and posterior veins than MSCT. Thus, retrograde CSA allows a better display of target vessels commonly used for cardiac interventions. Overall, these two imaging techniques offer complementary information.
authors.affiliation: Department of Cardiology, Pneumology, Vascular Medicine, University Hospital, RWTH Aachen University, Aachen, Germany. cknackstedt@ukaachen.de
authors.forename: Christian
authors.initials: C
authors.lastname: Knackstedt
authors.forename: Georg
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: Karl
authors.initials: K
authors.lastname: Mischke
authors.forename: Thomas
authors.initials: T
authors.lastname: Schimpf
authors.forename: Elmar
authors.initials: E
authors.lastname: Spüntrup
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Beyhan
authors.initials: B
authors.lastname: Sanli
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Patrick
authors.initials: P
authors.lastname: Schauerte
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
mesh_terms: D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D054326:Coronary Sinus / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000033:anatomy & histology*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D010690:Phlebography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide