Three Dimensional Visualization of Human Cardiac Conduction Tissue in Whole Heart Specimens by High-Resolution Phase-Contrast CT Imaging Using Synchrotron Radiation.
The feasibility of synchrotron radiation-based phase-contrast computed tomography (PCCT) for visualization of the atrioventricular (AV) conduction axis in human whole heart specimens was tested using four postmortem structurally normal newborn hearts obtained at autopsy.



A PCCT imaging system at the beamline BL20B2 in a SPring-8 synchrotron radiation facility was used. The PCCT imaging of the conduction system was performed with "virtual" slicing of the three-dimensional reconstructed images. For histological verification, specimens were cut into planes similar to the PCCT images, then cut into 5-μm serial sections and stained with Masson's trichrome.



In PCCT images of all four of the whole hearts of newborns, the AV conduction axis was distinguished as a low-density structure, which was serially traceable from the compact node to the penetrating bundle within the central fibrous body, and to the branching bundle into the left and right bundle branches. This was verified by histological serial sectioning.



This is the first demonstration that visualization of the AV conduction axis within human whole heart specimens is feasible with PCCT.
Department of Cardiac Surgery, Jikei University School of Medicine, Tokyo, Japan.
Gen
G
Shinohara
Department of Cardiac Surgery, Jikei University School of Medicine, Tokyo, Japan kiyozo@jikei.ac.jp.
Kiyozo
K
Morita
Japan Synchrotron Radiation Research Institute (SPring-8), Sayo-gun, Hyogo, Japan.
Masato
M
Hoshino
Department of Cardiac Surgery, Jikei University School of Medicine, Tokyo, Japan.
Yoshihiro
Y
Ko
Division of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital, Kobe, Japan.
Takuro
T
Tsukube
Division of Cardiovascular Surgery, National Medical Center for Children and Mothers, Tokyo, Japan.
Yukihiro
Y
Kaneko
Division of Cardiovascular Surgery, National Medical Center for Children and Mothers, Tokyo, Japan.
Hiroyuki
H
Morishita
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Yoshihiro
Y
Oshima
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Hironori
H
Matsuhisa
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Ryuma
R
Iwaki
Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Masashi
M
Takahashi
Division of Pathology, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan.
Takaaki
T
Matsuyama
Department of Cardiac Surgery, Jikei University School of Medicine, Tokyo, Japan.
Kazuhiro
K
Hashimoto
Japan Synchrotron Radiation Research Institute (SPring-8), Sayo-gun, Hyogo, Japan.
Naoto
N
Yagi
D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D002102:Cadaver; D003287:Contrast Media / Q000494:pharmacology*; D005240:Feasibility Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006329:Heart Conduction System / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media
atrioventricular conduction axis; cardiac anatomy/pathologic anatomy; conduction system; congenital heart disease (CHD); congenital heart surgery; imaging (all modalities); myocardial morphology