title: Quality of visualization of coronary venous system in 64-slice computed tomography.
abstract: BACKGROUND
  Multi-slice computed tomography (MSCT) can be used to visualize the anatomy of the coronary venous system (CVS). A pre-procedural evaluation of target veins is a very important element of cardiac resynchronization. Thus, the quality of visualization of the CVS is of great importance. The aim of this study was to analyze the quality of visualization of CVS in MSCT.
  
  
  METHODS
  In 220 subjects (129 male, average age 57.2 ± 11.8 years), a 64-slice CT (Aquilion 64, Toshiba, Japan) was performed. A scan with ECG-gating was performed using a slice thickness of 0.5 mm during a breath-hold. In each case, 3D volume rendering and 2D MPR reconstructions were created (Vitrea 2). The quality of visualization was graded independently by two cardiologists and a radiologist trained in MSCT on a 0-5 points scale for the coronary sinus and main veins [0 = not visible (lack of vein); 5 = visible as a smoothly bordered vascular structure].
  
  
  RESULTS
  The best visualization of the CVS was obtained for coronary sinus (4.10 ± 1.08), the worst for antero-lateral vein (2.11 ± 1.10). The average number of visible veins was 3.2 per case. Statistically, more veins were visible in older subjects - in the group aged 60+ the average number of visible veins was 3.6 ± 1.1 per case, whereas in those aged under 60 it was 2.9 ± 1.2 (p = 0.0001). There were no statistical gender differences in the quality of CVS visualization.
  
  
  CONCLUSIONS
  The target veins for cardiac resynchronization therapy should be the lateral and postero-lateral, which are usually well visible. Such a strategy could increase the usefulness of MSCT.
authors: Unit of Noninvasive Cardiovascular Diagnostics, Upper-Silesian Medical Centre, Katowice, Poland. agnieszkawlodyka@o2.pl
authors: Agnieszka
authors: A
authors: Młynarska
authors: Rafał
authors: R
authors: Młynarski
authors: Włodzimierz
authors: W
authors: Kargul
authors: Maciej
authors: M
authors: Sosnowski
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy; D057791:Cardiac Imaging Techniques / Q000379:methods / Q000592:standards*; D058406:Cardiac Resynchronization Therapy / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy; D003326:Coronary Circulation; D054326:Coronary Sinus / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*