Three-dimensional visualisation of coronary sinus ostium from the inside right atrium perspective.

Abstract

There is no in vivo method of coronary sinus visualisation from the right atrium perspective. The objective of the study was to create a cardiac computed tomography (CT) angiography-based method of visualising the coronary sinus ostium and the Thebesian valve from the inside right atrium perspective. In 78 consecutive patients, a cardiac CT angiography (Aquilion 64, Toshiba) with retrospective gating (slice 0.5 mm) was performed. Raw data were reconstructed on Vitrea 2 workstations (Vital Images). In order to create the three-dimensional (3D) coronary sinus visualisation from the "inside view" perspective, patented "Fly Through" algorithms were used, and the anatomical positions on the multiplanar reconstruction images were marked. A dedicated, Likert-based five-point scale was developed and used to evaluate the quality of the visualisations. The average quality of the visualisations of the coronary sinus ostium in two-dimensional multiplanar reconstruction images was good (4.17 ± 0.85 points) and was clinically interpretable in all cases. The image quality of the "inside view" 3D images was 3.61 ± 1.12 points. In 57.7% of cases we obtained high scores (4 and 5 points). The main diameter was 10.72 ± 2.48 mm, and the entrance angle of the coronary sinus into the right atrium was 103.76 ± 10.71°. Cardiac CT angiography is a useful method that permits the coronary sinus ostium and Thebesian valve to be visualised in vivo from the inside of the right atrium in a comparable manner.