title: Coronary magnetic resonance angiography and vessel wall imaging in children with Kawasaki disease.
abstract: BACKGROUND
  In patients with Kawasaki disease (KD) serial evaluation of the distribution and size of coronary artery aneurysms (CAA) is necessary for risk stratification and therapeutic management.
  
  
  OBJECTIVE
  To apply whole-heart coronary MR angiography (CMRA) and black-blood coronary vessel wall imaging in children with KD.
  
  
  METHODS
  Six children (mean age 4.6 years, range 2.5-7.8 years) with KD underwent CMRA using a free-breathing, T2-prepared, three-dimensional steady-state free-precession (3D-SSFP), whole-heart approach with navigator gating and tracking. Vessel walls were imaged with an ECG-triggered and navigator-gated double inversion recovery (DIR) black-blood segmented turbo spin-echo sequence.
  
  
  RESULTS
  There was complete agreement between CMRA and conventional angiography (n=6) in the detection of CAA (n=15). Excellent agreement was found between the two techniques in determining the maximal diameter (mean difference 0.2+/-0.7 mm), length (mean difference 0.1+/-0.8 mm) and distance from the ostium (mean difference -0.8+/-2.1 mm) of the CAAs. In all subjects with a CAA, abnormally thickened vessel walls were found (2.5+/-0.5 mm).
  
  
  CONCLUSIONS
  CMRA accurately defines CAA in free-breathing sedated children with KD using the whole-heart approach and detects abnormally thickened vessel walls. This technique may reduce the need for serial X-ray coronary angiography, and improve risk stratification and monitoring of therapy.
authors.affiliation: Department of Pediatric Cardiology, Children's Hospital, University of Tuebingen, Hoppe Seyler Strasse 1, 72076 Tuebingen, Germany. gerald.greil@med.uni-tuebingen.de
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Greil
authors.forename: Achim
authors.initials: A
authors.lastname: Seeger
authors.forename: Stephan
authors.initials: S
authors.lastname: Miller
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Michael
authors.initials: M
authors.lastname: Hofbeck
authors.forename: René M
authors.initials: RM
authors.lastname: Botnar
authors.forename: Ludger
authors.initials: L
authors.lastname: Sieverding
mesh_terms: D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000473:pathology; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results