Purpose
To evaluate the correlation between bridged coronary segments and atherosclerotic disease in patients who underwent 64-slice CT Coronary Angiography (CT-CA) (Fig. 1-4).
Methods and Materials
96 patients (77 male, mean age 60±11) who underwent 64-slice CT-CA for suspected or known coronary artery disease were reviewed for myocardial bridging. Segments proximal and distal to the bridging were evaluated for atherosclerotic plaques. Cross-sectional imaging, MPR, MIP, and VR were employed to display myocardial bridging and related atherosclerotic burden (Fig. 5).
Results
29 patients (30%, 24 male, mean age 58±12) presented single (86%) or double (14%) myocardial bridging with variable length (<1 cm in the 48%, 1-2 cm in the 40%, >2 cm in the 12%). Superficial (76%) or intramyocardial (24%) bridges were detected. Myocardial bridging was frequently localized in the mid-distal segment of the left anterior descending artery (93%). Coronary segments proximal to the bridge presented no atherosclerotic disease (n=7), positive remodelling (n=4), wall irregularities (n=4), <50% stenoses (n=9), >50% stenoses (n=6), or occlusion (n=3). 4...
Conclusions
64-slice CT-CA is a reliable method to non-invasively demonstrate myocardial bridging and related coronary atherosclerosis burden because of the high spatial resolution and flexible post-processing tools. 64-slice CT-CA provides new insight regarding atherosclerosis distribution in segments close to myocardial bridging that points out the link between a low shear stress and plaque formation (Fig. 17).
