ECG-Gated 심장 CT검사에서 다면 재구성 영상을 이용한 심근교 질환의 평가에 대한 유용성

Myocardial Bridging with ECG-Gated MDCT : Investigation into its incidence related with symptom and into symptonrrelated MDCT parameter in multiplanar reformatting images

Purpose To evaluate the incidence of myocardial bridging in symptomatic and asymptomatic patients and to investigate whether there is any parameter related to symptom in ECG-gated MDCT with multiplanar reformation. Materials and Methods 1030 patients were involved in this study. They consisted of the patients with atypical chest pain (n = 583) and who were referred for health screening (n = 447). MDCT scans were performed with two different 64-MDCT scanners (Light Speed VCT 64, GE and Sensation Cardiac 64, Siemens). We evaluated following parameters which are assumed to determine significance of myocardial bridging after multi planar reformation on MDCT : the depth and length of tunneled artery, and visualization of milking effect. To find out which parameter is related to symptom, we used Fisher’s exact test and Mann-Whitney U test, statistically. Results Among the 985 patients, 31 cases (3.1%) of myocardial bridging were detected. Incidences of myocardial bridging were 2.7 % in symptomatic patients and 3.4 % in asymptomatic patients, without statistical difference(p > 0.05). Most common location of myocardial bridging was at the middle third of the left anterior descending coronary artery (n = 25/31, 80.6%). Of these patients, the length of tunneled artery was between 11 and 48 mm (mean : 24 mm), and the depth of tunneled artery was between 0 and 8.5 mm (mean : 3.1 mm). The milking effect was observed in 19 of 23 patients (82.6%), but there was no specific parameter related to symptom, statistically (p > 0. 05). Conclusion It is known that the patients with myocardial bridging show variable clinical symptom, from no specific symptom to sudden death. In our study, there was no statistical difference of the incidence of myocardial bridging between symptomatic and asymptomatic patients, and there was no symptom-related specific parameter which determines significance of myocardial bridging in ECG-gated MDCT with multiplanar reformation.