Studying coronary veins with Dual Source CT

Vladimir Mendoza, Cardiologist, Cuba has sent the following question:

Coronary veins:
How we can study the complete coronary vein with DSCT in patients with DMC?

U. Joseph Schoepf, M.D., Medical University of South Carolina:

The protocol for studying coronary veins is not technically different from regular coronary CT angiography as far as ECG-synchronization and general scanner settings are concerned. However, the coronary venous system enhances somewhat later than the coronary arteries, which should be taken into consideration when planning the study. For dedicated evaluation of the coronary venous system, e.g. prior to biventricular pacing, one may use a somewhat longer scan delay (e.g. 5 seconds longer) than for coronary artery studies. Alternatively, a test bolus (ca. 20cc of contrast) can be injected in order to determine the bolus arrival time in the coronary sinus.