[Value of multislice spiral computed tomography in finding coronary artery lesion in children with Kawasaki disease].
OBJECTIVE
Kawasaki disease is an acute systemic vasculitis syndrome primarily affecting small and medium-sized arteries, with development of severe coronary artery lesion (CAL). CAL may induce myocardial infarction and sudden death. So it is very important to find CAL early. In this study the value of multislice spirral computed tomography (MSCT) was investigated to find CAL in patients with Kawasaki disease.


METHODS
Thirty-four patients with Kawasaki disease were examined respectively by using MSCT and two dimensional echocardiography (TDE), then the findings were analyzed.


RESULTS
MSCT showed CAL in 12 of 34 patients involving 16 coronary arteries, including 9 (26%) dilated left coronary arteries (LCA), 1 constricted, 1 calcified and 1 LCA which had both stenosis and 4 (12%) dilated right coronary artery. TDE showed that 10 patients had 13 dilated coronary arteries, including 7 (21%) left coronary arteries and 6 (18%) right coronary arteries. TDE failed to show the abnormalities in 3 patients with coronary artery stenosis or calcification and in 2 patients with left descending artery dilation demonstrated by MSCT. However, no significant difference was found between the two methods (P > 0.05) in the rates of positive findings. The correlation between TDE and MSCT, in left as well as right coronary artery, was significantly positive (r = 0.90, r = 0.82, respectively, P < 0.01). However, compared with TDE, MSCT was significantly better in finding coronary artery stenosis and calcification (chi(2) = 24.3, P < 0.01).


CONCLUSIONS
Use of MSCT may help better find the lesions of coronary artery, especially those in middle and distant sections as compared to TDE. MSCT is better than TDE in exploring coronary wall calcification and coronary artery stenosis. MSCT could be a helpful new addition to the current CAL monitoring method in long-term follow-up of patients with Kawasaki disease.
Yu
Xian-yi
XY
Department of Pediatrics, Second Hospital, China Medical University, Shenyang 110004, China.
Wang
Hong
H
Hou
Yang
Y
Chen
Rui
R
Xing
Yan-lin
YL
D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed