Abstract
Objective: We investigated the appropriate reconstruction interval required to generate optimal quality images of the coronary veins and to evaluate the size of each vein at the systolic and diastolic phases using coronary computed tomography (CT) venography. Methods: Coronary CT venograms obtained from 30 patients using 64-slice CT were reconstructed at 0% to 90% of the cardiac cycle in 10% increments. Two radiologists assessed the image quality of the anterior interventricular vein (AIV), the great cardiac vein (GCV), the posterior vein of the left ventricle (PVLV), the posterior interventricular vein (PIV), the coronary sinus (CS) and the small cardiac vein (SCV). We determined the sizes of measurable CS (n = 16) and GCV (n = 12) at the end systolic and mid diastolic phases. Results: The most appropriate reconstruction point for all coronary veins turned out to be at the mid-diastolic phase. The size of the CS and GCV was greater at a 30% than that at a 70% R-R interval (p Conclusions: Image quality was optimal at the mid-diastolic phase for each coronary vein, but the sizes of the coronary veins varied during the cardiac cycle. The cardiac cycle must be considered when measuring the sizes of cardiac veins.
Highlights
Successful percutaneous procedures such as biventricular pacing [1,2], catheter ablation [2,3], cellular cardiomyoplasty [4], and percutaneous mitral valve annuloplasty [5] require considerable understanding of the cardiac veins
We investigated the appropriate reconstruction interval required to generate optimal quality images of the coronary veins and to evaluate the size of each vein at the systolic and diastolic phases using coronary computed tomography (CT) venography
Image quality was optimal at the mid-diastolic phase for each coronary vein, but the sizes of the coronary veins varied during the cardiac cycle
Summary
Successful percutaneous procedures such as biventricular pacing [1,2], catheter ablation [2,3], cellular cardiomyoplasty [4], and percutaneous mitral valve annuloplasty [5] require considerable understanding of the cardiac veins. Multidetector row computed tomography (MDCT) with retrospective electrocardiogram (ECG)-gating and intravenous administration of contrast medium provides accurate images of cardiac structures with high spatial resolution less invasive. Such measurement of the coronary venous system helps plan preoperatively for several procedures mentioned above [5,7,8,9,10]. ECG-gated MDCT images are generally reconstructed at a point between end systole and mid diastole that represents minimal cardiac motion. The size of the coronary sinus differs during the cardiac cycle, and coronary veins have not been numerically compared among the cardiac cycle using MDCT
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