Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization
- 224 Downloads
After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically.
To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS.
Materials and methods
A total of 16 patients (aged 5–27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T).
There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI—one stenosis was missed.
MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS.
KeywordsKawasaki syndrome Multidetector CT MRA Children
The authors acknowledge Toshiba and Siemens for providing imaging assistance and special on-site training. Patient I.E. was referred by Dr. M. Freund (UMC Utrecht, The Netherlands) and Dr. O. Krogmann (Duisburg Paediatric Heart Centre, Germany). Dr. Freund also kindly provided recent coronary angiograms of the patient. The MRI examinations were performed by Mrs. S. Yubai (RT) and Mrs. K. Knauer (RT) with enthusiasm and excellent patient care. The authors are very grateful to Dipl. Ing Mews (Toshiba) and Dipl. Ing. Knoch (University Heidelberg) for calculation of the effective radiation doses.
- 3.Newburger JW, Takahashi M, Gerber MA et al (2004) Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110:2747–2771PubMedCrossRefGoogle Scholar