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Published in: Pediatric Radiology 11/2006

01-11-2006 | Original Article

Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography

Authors: Winnie C. W. Chu, Geoffrey C. F. Mok, Wynnie W. M. Lam, Man-ching Yam, Rita Y. T. Sung

Published in: Pediatric Radiology | Issue 11/2006

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Abstract

Background

Transthoracic ECHO is the locally accepted method for coronary surveillance of patients with Kawasaki disease but it may have limited visualization in the older child.

Objective

To assess the feasibility of multidetector CT (MDCT) angiography in the follow-up of coronary artery aneurysms in children with previous Kawasaki disease.

Materials and methods

Six children (5 boys, 1 girl; mean age 11.5 years) with known Kawasaki disease and coronary artery involvement underwent CT coronary angiography using 16-detector MDCT. The visualized lengths and diameter of all coronary segments were measured. The number, size and location of coronary artery aneurysms were recorded and compared with recent ECHO.

Results

Twelve coronary artery aneurysms (seven saccular, five fusiform) were identified by MDCT angiography. One saccular aneurysm at the junction of the distal right coronary artery and posterior descending artery was not detected by ECHO while the remaining six in proximal segments were detected by both modalities. Two of five fusiform aneurysms were not detected by ECHO due to their small sizes. Excellent agreement was found between CT and ECHO for maximal diameter and length of the visualized aneurysms.

Conclusions

MDCT angiography accurately defines coronary artery aneurysms. It is more sensitive for detecting aneurysms at distal coronary segments and fusiform aneurysms of small size.
Literature
1.
go back to reference Burns JC, Kushner HI, Bastian JF, et al (2000) Kawasaki disease: a brief history. Pediatrics 106:E27PubMedCrossRef Burns JC, Kushner HI, Bastian JF, et al (2000) Kawasaki disease: a brief history. Pediatrics 106:E27PubMedCrossRef
2.
go back to reference Du ZD, Zhang T, Liang L, et al (2002) Epidemiologic picture of Kawasaki disease in Beijing from 1995 through 1999. Pediatr Infect Dis J 21:103–107PubMedCrossRef Du ZD, Zhang T, Liang L, et al (2002) Epidemiologic picture of Kawasaki disease in Beijing from 1995 through 1999. Pediatr Infect Dis J 21:103–107PubMedCrossRef
3.
go back to reference Park YW, Han JW, Park IS, et al (2005) Epidemiologic picture of Kawasaki disease in Korea, 2000–2002. Pediatr Int 47:382–387PubMedCrossRef Park YW, Han JW, Park IS, et al (2005) Epidemiologic picture of Kawasaki disease in Korea, 2000–2002. Pediatr Int 47:382–387PubMedCrossRef
4.
go back to reference Chang RK (2002) Hospitalizations for Kawasaki disease among children in the United States, 1988–1997. Pediatr Infect Dis J 21:1150–1155PubMedCrossRef Chang RK (2002) Hospitalizations for Kawasaki disease among children in the United States, 1988–1997. Pediatr Infect Dis J 21:1150–1155PubMedCrossRef
5.
go back to reference Lue HC, Philip S, Chen MR, et al (2004) Surveillance of Kawasaki disease in Taiwan and review of the literature. Acta Paediatr Taiwan 45:8–14PubMed Lue HC, Philip S, Chen MR, et al (2004) Surveillance of Kawasaki disease in Taiwan and review of the literature. Acta Paediatr Taiwan 45:8–14PubMed
6.
go back to reference Yanagawa H, Nakamura Y, Ysahiro M, (2001) Incidence survey of Kawasaki disease in 1997 and 1998 in Japan. Pediatrics 107:E33PubMedCrossRef Yanagawa H, Nakamura Y, Ysahiro M, (2001) Incidence survey of Kawasaki disease in 1997 and 1998 in Japan. Pediatrics 107:E33PubMedCrossRef
7.
go back to reference Hirohisa K, Tetsu S, Teiji A, et al (1996) Heart and vascular Disease in the young: long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients. Circulation 94:1379–1385 Hirohisa K, Tetsu S, Teiji A, et al (1996) Heart and vascular Disease in the young: long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients. Circulation 94:1379–1385
8.
go back to reference Nakamura Y, Yanagawa H, Harada K, et al (2000) Mortality among persons with a history of Kawasaki disease in Japan: existence of cardiac sequelae elevated the mortality. J Epidemiol 10:372–375PubMed Nakamura Y, Yanagawa H, Harada K, et al (2000) Mortality among persons with a history of Kawasaki disease in Japan: existence of cardiac sequelae elevated the mortality. J Epidemiol 10:372–375PubMed
9.
go back to reference Nakamura Y, Aso E, Yashiro M, et al (2005) Mortality among persons with a history of Kawasaki disease in Japan: can paediatricians safely discontinue follow-up of children with a history of the disease but without cardiac sequelae? Acta Paediatr 94:429–434PubMedCrossRef Nakamura Y, Aso E, Yashiro M, et al (2005) Mortality among persons with a history of Kawasaki disease in Japan: can paediatricians safely discontinue follow-up of children with a history of the disease but without cardiac sequelae? Acta Paediatr 94:429–434PubMedCrossRef
10.
go back to reference Newburger JW, Takahashi M, Gerber MA, et al (2004) Diagnosis, treatment and long-term management of Kawasaki disease: a statement for health professionals form the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 114:1708–1733PubMedCrossRef Newburger JW, Takahashi M, Gerber MA, et al (2004) Diagnosis, treatment and long-term management of Kawasaki disease: a statement for health professionals form the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 114:1708–1733PubMedCrossRef
11.
go back to reference Ministry of Health and Welfare (1984) Report of the Subcommittee on Standardization of Diagnostic Criteria and Reporting of Coronary Artery Lesions in Kawasaki Disease. Research Committee on Kawasaki disease, Ministry of Health and Welfare, Tokyo, Japan Ministry of Health and Welfare (1984) Report of the Subcommittee on Standardization of Diagnostic Criteria and Reporting of Coronary Artery Lesions in Kawasaki Disease. Research Committee on Kawasaki disease, Ministry of Health and Welfare, Tokyo, Japan
12.
go back to reference Iemura M, Ishii M, Sugimura T, et al (2000) Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart 83:307–311PubMedCrossRef Iemura M, Ishii M, Sugimura T, et al (2000) Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart 83:307–311PubMedCrossRef
13.
go back to reference Tsuda E, Kamiya T, Ono Y, et al (2005) Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart 91:177–182PubMedCrossRef Tsuda E, Kamiya T, Ono Y, et al (2005) Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart 91:177–182PubMedCrossRef
14.
go back to reference Sugimura T, Yokoi H, Sato N, et al (1997) Interventional treatment for children with severe coronary artery stenosis with calcification after long-term Kawasaki disease. Circulation 96:3928–3933PubMed Sugimura T, Yokoi H, Sato N, et al (1997) Interventional treatment for children with severe coronary artery stenosis with calcification after long-term Kawasaki disease. Circulation 96:3928–3933PubMed
15.
go back to reference Hiraishi S, Misawa H, Takeda N, et al (2000) Transthoracic ultrasonic visualization of coronary aneurysm, stenosis and occlusion in Kawasaki disease. Heart 83:400–405PubMedCrossRef Hiraishi S, Misawa H, Takeda N, et al (2000) Transthoracic ultrasonic visualization of coronary aneurysm, stenosis and occlusion in Kawasaki disease. Heart 83:400–405PubMedCrossRef
16.
go back to reference Wu MT, Hsieh KS, Lin CC, et al (2004) Images in cardiovascular medicine. Evaluation of coronary artery aneurysms in Kawasaki disease by multislice computed tomographic coronary angiography. Circulation 110:e339PubMedCrossRef Wu MT, Hsieh KS, Lin CC, et al (2004) Images in cardiovascular medicine. Evaluation of coronary artery aneurysms in Kawasaki disease by multislice computed tomographic coronary angiography. Circulation 110:e339PubMedCrossRef
17.
go back to reference Goo HW, Park IS, Ko JK, et al (2006) Coronary CT angiography and MR angiography in Kawasaki disease. Pediatr Radiol 36:697–705PubMedCrossRef Goo HW, Park IS, Ko JK, et al (2006) Coronary CT angiography and MR angiography in Kawasaki disease. Pediatr Radiol 36:697–705PubMedCrossRef
18.
go back to reference Sohn S, Kim HS, Lee SW (2004) Multidetector row computed tomography for follow up of patients with coronary artery aneurysms due to Kawasaki disease. Pediatr Cardiol 25:35–39PubMedCrossRef Sohn S, Kim HS, Lee SW (2004) Multidetector row computed tomography for follow up of patients with coronary artery aneurysms due to Kawasaki disease. Pediatr Cardiol 25:35–39PubMedCrossRef
19.
go back to reference Kanamaru H, Sato Y, Takayama T, et al (2005) Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease. Am J Cardiol 95:522–525PubMedCrossRef Kanamaru H, Sato Y, Takayama T, et al (2005) Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease. Am J Cardiol 95:522–525PubMedCrossRef
20.
go back to reference Greil GF, Stuber M, Botnar RM, et al (2002) Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease. Circulation 105:908–911PubMedCrossRef Greil GF, Stuber M, Botnar RM, et al (2002) Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease. Circulation 105:908–911PubMedCrossRef
21.
go back to reference Lau GT, Ridley LJ, Schieb MC, et al (2005) Coronary artery stenosis: detection with calcium scoring, CT angiography, and both methods combined. Radiology 235:415–422PubMedCrossRef Lau GT, Ridley LJ, Schieb MC, et al (2005) Coronary artery stenosis: detection with calcium scoring, CT angiography, and both methods combined. Radiology 235:415–422PubMedCrossRef
22.
go back to reference Schroeder S, Kopp AF, Baumbach A, et al (2001). Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 37:1430–1435PubMedCrossRef Schroeder S, Kopp AF, Baumbach A, et al (2001). Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 37:1430–1435PubMedCrossRef
23.
go back to reference Becker CR, Knez A, Ohnesorge B, et al (2000) Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating. AJR 175:423–424PubMed Becker CR, Knez A, Ohnesorge B, et al (2000) Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating. AJR 175:423–424PubMed
Metadata
Title
Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography
Authors
Winnie C. W. Chu
Geoffrey C. F. Mok
Wynnie W. M. Lam
Man-ching Yam
Rita Y. T. Sung
Publication date
01-11-2006
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 11/2006
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-006-0281-4

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