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Myocardial bridging(MB) is considered as a congenital condition. Usually, coronary artery runs through epicardially. Myocardial bridging occurs when a segment of a coronary artery or its major branch travels intramurally through the myocardium. The myocardium overlying the intramural segment of epicardial coronary artery is called a myocardial bridging, and the artery coursing within the myocardium is called a “tunneled artery”. It may dip into the myocardium for varying lengths. The mid portion of left anterior coronary artery has been reported as the most frequent site of myocardial bridges. This phenomenon was first described by Grainicianu in the early 1920s. In 1960, Portmann and Iwig first reported the radiological appearance of transient occlusion in a segment of the left anterior descending coronary artery during systole. A large discrepancy exists between pathological series, in which the incidence has varied from 15% to 85%, and angiographic series, in which it is reported as being between 0.51% and 2.5%. The clinical significance of MB is controversial. Myocardial bridging has been shown linking to clinical complications that include ischemia, acute coronary syndrome, coronary spasm, arrhythmia, and sudden death, although in the vast majority of cases, myocardial bridging remains clinically silent. Coronary angiography remains the current gold standard for diagnosing MB. Lower prevalence of myocardial bridging on coronary angiography may partly due to thin bridging. In addition, coronary angiography is an invasive technique with complications and risks. Until now, intravascular ultrasound (IVUS) is the most accurate method to diagnose MB. Intracoronary Doppler ultrasound (ICD) has also been used in the diagnosis of bridging. However, they are all invasive and expensive and not routinely used in clinical settings. Therefore, the need for a non-invasive technique for detection of bridging has emerged. While multi-detector computed tomography (MDCT) angiography is faster and more adequate, it has the ability to assess the course and the anatomic relationships of the coronary arteries. With the advent of high-resolution magnetic resonance imaging and shorter scan time, it will have a bright future for the reason of no contrast and radiation. In this paper, we will discuss the non-invasive method to detect myocardial bridging in comparison to invasive technique.

Detection Myocardial Bridging Using Non-Invasive Technique