Magnetic resonance angiography, function and viability evaluation in patients with Kawasaki disease.
OBJECTIVE
We evaluated the ability of magnetic resonance imaging to perform a noninvasive assessment of coronary arteries, function and viability in one examination in a population with Kawasaki disease.


BACKGROUND
Magnetic resonance angiography (MRA) can identify coronary abnormalities in patients with Kawasaki disease (KD). Contrast enhanced cardiovascular magnetic resonance (CeCMR) is the current gold standard for scar detection. Steady-state, free precession (SSFP) cine is a reliable technique to evaluate myocardial function and wall motion.


METHODS
Twenty patients with KD aged 7-12 yrs, were examined. Coronary MRA was performed using a 1.5 T system with two ECG-triggered pulse sequences. CeCMR images were acquired 15 minutes after the i.v. injection of 0.1 mmol/kg Gd-DTPA using an inversion recovery sequence. SSFP cines were acquired using 6-mm short-axis slices from the atrioventricular ring to the apex.


RESULTS
Aneurysms of the coronary arteries were identified in 7 patients and coronary ectasia was present in the remaining 12 patients while 1 patient had both. Transmural anterior-apical scar was detected by ceCMR in two cases, while small inferior necrosis was identified in another 2 cases. Left ventricular function was deteriorated only in the two patients with antero-apical infarction. The presence of myocardial infarction was detected in the territory supplied by the involved coronary artery.


CONCLUSIONS
In Kawasaki disease MRA, SSFP cine and ceCMR are able to perform noninvasive coronary artery evaluation, function and infarct detection in a single study.
Mavrogeni
Sophie
S
Onassis Cardiac Surgery Center, Athens, Greece. soma@aias.gr
Papadopoulos
George
G
Douskou
Marouso
M
Kaklis
Savas
S
Seimenis
Ioannis
I
Varlamis
George
G
Karanasios
Evangelos
E
Krikos
Xenofon
X
Giannoulia
Aglaia
A
Cokkinos
Dennis V
DV
D002648:Child; D003287:Contrast Media; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography
D003287:Contrast Media; D019786:Gadolinium DTPA