Visualization of sinus node arteries by multislice spiral computed tomography coronary angiography
Objective: to assess the capabilities of multislice spiral com­puted tomography coronary angiography (MSCT-CA) to visual­ize the anatomy of the sinus node artery (SNA). Material and methods. The retrospective analysis of coronary artery examinations covered 46 patients with the referral diagno­sis of coronary heart disease. MSCT-CA showed no evidence of coronary artery stenosis. This sample included 23 (50%) men and 23 (50%) women; the mean age of the patients was 52.4 ±9.1 years; the mean height was 170±6.67 cm; the mean weight was 80.7± 12.1 kg. X-ray computed tomography was carried out using a SOMATOM Definition AS+ 128-slice computed tomography scanner with retrospective ECG synchronization, reconstructed slice thicknesses of 1 and 3-mm. The Spearman correlation test was used for statistical data analysis. Results. The SNA was visualized in 83% of the patients. It ori­ginated from the right coronary artery (RCA) and the circumflex branch of the left coronary artery in 84 and 16% of cases, respecti­vely. No significant association was found between the type of heart blood supply and that of sinus node one (r = 0.06). In 18% of cases, the SNA was visualized only at the level of the ostium, allo­wing the assessment of the origin of the artery, and at the level of its mid-third in 32%; the distal SNA bed was visualized up to its division; in 10% of them the artery could be visualized all the way, including the division (the dissipation site). Unclear visualization of the proximal SNA was observed among 17% of the patients in whom the SNA could not be visualized with a heart rate (HR) of more than 80 beats/min in 62.5% of the patients, less than 41 beats/min in 12.5%, and 60-61 beats/min in 25%. HR was not found to be associated with the quality of SNA visualization (r = 0.09). Conclusion. MSCT can assess the anatomy of SNA up to the distal bed and dissipation site. In the overwhelming majority of the patients, the SNA originated from the RCA (84%) regardless of the type of heart blood sup­ply. The best SNA visu­alization was noted with a HR of 50 to 80 beats per minute. There was no statistical relation­ship of the quality of visualization to HR