Current Research and Scholarly Interests
Purpose
Myocardial bridges (MB) with associated upfront atherosclerotic lesions are common findings on coronary computed tomography angiography (CTA). Abnormal septal wall motion in exercise echocardiography (EE) may to be associated with MB. Intravascular ultrasound (IVUS) is considered the gold standard for the detection of MB. The purpose of this study was to investigate whether CTA is comparable to IVUS for the assessment of MB and upstream plaques in symptomatic patients with suspicion for MB raised by EE.
Materials and Methods
We reviewed our clinical database from 2009-2014 for patients who had chest pain and EE suggestive for MB. We analyzed both CT and IVUS for atherosclerotic plaques, distance, coverage, compression and length of MB and embedded side branches. Bland-Altman, t-test and ANOVA were performed to compare these measurements.
Results
Fifty-nine patients (13-72 years) were identified. Considering IVUS as the gold standard, CTA had sensitivity for MB, plaque and side branches detection of 100%, 43,8% and 57,4%, respectively. The systematic error and limit of agreement between CTA and IVUS for the distance and length was 3.2±30.9 mm and 2.2±25.8 mm, respectively. There was a significant correlation between the CTA bridge coverage and the IVUS myocardial bridge thickness, but no correlation between CTA coverage and IVUS compression. Sensitivity and specificity for the detection of plaques was 43.8% and 100%, respectively.
Conclusion
CTA compares well with IVUS for the assessment of MB, however performs only moderate for the detection of atherosclerotic lesions and embedded side branches.
