Background: Multi-slice computed tomography (MSCT) can be used to visualize the anatomy
of the coronary venous system (CVS). A pre-procedural evaluation of target veins is a very important
element of cardiac resynchronization. Thus, the quality of visualization of the CVS is of great
importance. The aim of this study was to analyze the quality of visualization of CVS in MSCT.
Methods: In 220 subjects (129 male, average age 57.2 ± 11.8 years), a 64-slice CT (Aquilion 64,
Toshiba, Japan) was performed. A scan with ECG-gating was performed using a slice thickness of
0.5 mm during a breath-hold. In each case, 3D volume rendering and 2D MPR reconstructions
were created (Vitrea 2). The quality of visualization was graded independently by two cardiologists
and a radiologist trained in MSCT on a 0-5 points scale for the coronary sinus and main veins
[0 = not visible (lack of vein); 5 = visible as a smoothly bordered vascular structure].
Results: The best visualization of the CVS was obtained for coronary sinus (4.10 ± 1.08), the
worst for antero-lateral vein (2.11 ± 1.10). The average number of visible veins was 3.2 per
case. Statistically, more veins were visible in older subjects - in the group aged 60+ the
average number of visible veins was 3.6 ± 1.1 per case, whereas in those aged under 60 it was
2.9 ± 1.2 (p = 0.0001). There were no statistical gender differences in the quality of CVS
visualization.
Conclusions: The target veins for cardiac resynchronization therapy should be the lateral and
postero-lateral, which are usually well visible. Such a strategy could increase the usefulness of
MSCT. (Cardiol J 2011; 18, 2: 146-150