Improvement in the quality of the cardiac vein images by optimizing the scan protocol of multidetector-row computed tomography

The present study aimed at optimizing the scan protocol for multidetector-row computed tomography (MDCT) to adequately visualize coronary veins. Circulation time (Cir.T) was defined as the time period from the injection of contrast media into the coronary artery to the pervasion of the contrast media into the coronary sinus as observed by coronary angiography. We investigated the relation between the Cir.T and echocardiographic parameters in 64 patients. The left ventricular end-diastolic diameter (LVDd) and left ventricular end-systolic diameter (LVDs) were correlated with the Cir.T (r = 0.58, P < 0.0001, and r = 0.60, P < 0.0001 respectively). In addition, the left ventricular ejection fraction (LVEF) was negatively correlated with the Cir.T (r = 0.48, P < 0.0001). The average Cir. T was longer in patients with LVEF < 35% (8.0 s vs 6.7 s; P < 0.05) or LVDd > 55 mm (7.9 s vs 6.2 s; P < 0.05) than in the other patients. The quality of the MDCT images of the coronary veins obtained at different scan timings (coronary artery phase and 10 s or 15 s after the coronary artery phase) were graded and classified into four categories (0 = worst, 3 = best) in 25 patients with LVEF < 35%. The delays of 10 and 15 s after the coronary artery phase significantly improved the mean image quality (P < 0.05). The Cir.T was prolonged in patients with low LVEF and LV dilation. An appropriate delay improved the quality of the MDCT images of the coronary veins in patients with LV dysfunction.