Detection of Myocardial Bridging by 64-Row Computed Tomography Angiography of the Coronaries

Abstract

Myocardial bridging is a congenital condition in which a section of coronary artery is surrounded by myocardium. Historically, myocardial bridging has been diagnosed by catheter angiography. This study investigates the effectiveness of electrocardiogram-gated 64-slice multidetector computed tomography in detecting myocardial bridging. We retrospectively reviewed 167 consecutive patients referred for coronary computed tomography angiography between January 4, 2005, and May 24, 2006. We recorded the number of coronary segments exhibiting myocardial bridging and described the location of each according to the American Heart Association classification system. Association of bridging with factors influencing image quality (body mass index and heart rate) was analyzed. Of 152 eligible participants, 49 (32%) showed myocardial bridging. The mid-left anterior descending coronary artery (segment 7) was the most common location accounting for 69% of positive cases. Body mass index and heart rate did not affect detection rates. Electrocardiogram-gated 64-slice multidetector computed tomography is a feasible, noninvasive method of detecting myocardial bridging which may offer higher sensitivity than catheter angiography for this diagnosis.