Assessment of coronary artery lesions in children with Kawasaki disease: evaluation of MSCT in comparison with 2-D echocardiography

Pediatr Radiol. 2009 Nov;39(11):1209-15. doi: 10.1007/s00247-009-1364-9. Epub 2009 Aug 11.

Abstract

Background: Transthoracic two-dimensional echocardiography is an effective method for detecting coronary arterial injury in Kawasaki disease. However, its accuracy in the diagnosis of coronary arterial lesions is limited.

Objective: To investigate the value of multislice spiral CT for coronary angiography for observing the coronary arterial injury caused by infantile Kawasaki disease.

Materials and methods: Coronary angiography, using a 64-slice spiral CT scanner, and 2-D echocardiography were performed in 48 children with Kawasaki disease in whom the position, internal diameter, and length of each coronary artery were measured.

Results: MSCT showed coronary artery injury in 15 of the 48 children. Among these 15 children, 20 coronary artery branches showed complications, including the left coronary artery branches in 15 (31.2%) and the right coronary artery branches in 5 (10.4%). Complications in the left coronary artery branches included dilation in 12 (25.0%) and stenosis, calcification and the combination of the two in one each, and the right coronary artery branches showed dilation; two branches also showed beaded changes. MSCT also showed dilation in the left anterior descending arteries in two children. These children showed no abnormality on 2-D echocardiography.

Conclusion: MSCT is a valuable examination method for detecting coronary artery injury in Kawasaki disease.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Child
  • Child, Preschool
  • Coronary Angiography / methods*
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / diagnostic imaging*
  • Echocardiography / methods*
  • Female
  • Humans
  • Infant
  • Male
  • Mucocutaneous Lymph Node Syndrome / complications*
  • Mucocutaneous Lymph Node Syndrome / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*