Purpose: The objective of this study was to characterize cervical computed tomography (CT) findings in Kawasaki disease (KD) patients that may facilitate early diagnosis.
Methods: We retrospectively reviewed cervical CT images of 78 children with cervical lymphadenopathy to analyze the distribution and morphology of lymphadenopathy and other soft-tissue findings.
Results: Twenty-eight patients were diagnosed with KD. Fifty had other diseases (non-KD). Retropharyngeal edema was observed in 82% (23/28) of KD and 30% (15/50) of non-KD (P < 0.01) cases. Retropharyngeal lymphadenopathy was observed in 89% (25/28) of KD and 48% (24/50) of non-KD (P < 0.01) cases. Levels III and IV lymphadenopathy was found in only 1 KD case, whereas levels III and IV lymphadenopathy was found in 58% (29/50) (P < 0.01) and 36% (18/50) (P < 0.01) of non-KD cases, respectively.
Conclusions: Retropharyngeal lymphadenopathy and retropharyngeal edema are relatively common features of KD on CT. Given the potentially serious complications of KD, this diagnosis is an important consideration in a young child presenting with these imaging findings.