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Myocardial Bridge: Evaluation on MDCT

Abdel-Rauf Zeina1,2, Majed Odeh2,3, Jorge Blinder4, Uri Rosenschein2,5 and Elisha Barmeir1,2

1 Department of Radiology and MAR Imaging Institute, Bnai Zion Medical Center, 47, Golomb St., P.O.B. 4940, Haifa, Israel.
2 Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel.
4 MAR Imaging Institute, Bikur Holim Hospital, Jerusalem, Israel.
5 Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel.


Figure 1
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  		Fig. 1A —58-year-old man with atypical chest pain. ECG-gated coronary CT angiography performed with 16-MDCT. Curved multiplanar reformat image shows band of myocardial muscle overlying mid left anterior descending artery (LAD) segment corresponding to myocardial bridge (arrows). No wall abnormality of coronary artery segment proximal to and under bridge is noted. LMCA = left main coronary artery, LCX = left circumflex artery, LV = left ventricle.

 

Figure 2
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  		Fig. 1B —58-year-old man with atypical chest pain. ECG-gated coronary CT angiography performed with 16-MDCT. Cross-section image shows tunneled segment completely surrounded by muscle fibers (arrow).

 

Figure 3
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  		Fig. 2 —53-year-old man with typical chest pain but inconclusive stress tests. Coronary CT angiography was performed with 64-MDCT. Curved multiplanar reformat image shows atheromatous changes (calcified and soft plaques) only in left anterior descending artery (LAD) segment proximal to bridge (solid arrows), causing significant stenosis (open arrows). Note that tunneled segment and distal LAD segment are spared. LV = left ventricle.

 

Figure 4
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  		Fig. 3 —61-year-old man after percutaneous coronary intervention. Coronary CT angiography was performed with 64-MDCT. Curved multiplanar reformat image shows stent in mid left anterior descending artery (LAD), immediately before bridge (arrows). Arrowhead indicates mixed plaque. LV = left ventricle.

 

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