Imaging the coronary venous drainage system using electron-beam CT

This study describes the appearance of the coronary sinus and its tributary veins as visualized on EGG-triggered electron-beam computed tomography (CT ) and investigates their spatial relationship to other cardiac structures. Thirty-two patients were examined with EGG-triggered electron-beam CT (expo sure time: 100 ms, slice thickness: 1.5 mm) after intravenous contrast agen t administration. The entire heart was imaged; the appearance of the corona ry sinus and its tributary veins were evaluated. In all 32 patients the ant erior interventricular vein and the posterior interventricular vein drained into the coronary sinus. The small cardiac vein was visualized in five pat ients, a posterior vein of the left ventricle in three and the left margina l vein in eleven. The coronary sinus of all 32 patients had a average lengt h of 30 mm +/- 10 mm (mean +/- SD), range: 21-40 mm and a diameter of 9 mm +/- 5 mm (mean +/- SD), range: 4-14 mm. The results of our work show that i f the entire heart volume is scanned using ECG-triggered electron-beam CT, the delineation and the differentiation of the major cardiac veins is possi ble on transverse cross sections in a way which corresponds to the anatomic al literature. Hence to the similar enhancement and similar diameter of cor onary veins and arteries on contrast-enhanced electron-beam CT studies, the radiologist should be familiar with the cross-sectional anatomy of the maj or cardiac veins to prevent possible misinterpretation.