[Advantages of multislice spiral computed tomography for evaluation of serious coronary complications after Kawasaki disease].
OBJECTIVE
Novel multislice spiral computed tomography (MSCT) findings were identified in patients after Kawasaki disease that could not be detected by coronary angiography (CAG).


METHODS
Eighteen patients had suffered from serious coronary arterial lesions after Kawasaki disease (mean age 21.7 years, range 13-34 years). Seventeen patients had stenotic lesions, and all of them had coronary aneurysms. MSCT was performed using a Siemens SOMATOM Volume Zoom (4-detector row) or a Toshiba Aquillion 16 (16-detector row). Findings of coronary calcification, stenotic lesion, and intimal hypertrophy in all coronary arteries were compared to those of CAG.


RESULTS
Eleven of the 18 patients (61%) had novel findings detected by MSCT. Coronary calcifications were found in 11 of the 18 patients (61%). Five patients had concentric calcified aneurysms, four had eccentric calcified aneurysms, and two had mixed calcified aneurysms. Coronary stenotic lesions were present in 6 of the 18 patients (33%) with calcified aneurysms. Two patients had intimal hypertrophy (11%). One patient had intimal hypertrophy along the left main trunk with a giant calcified aneurysm along the left anterior descending artery. Two patients had severe stenoses just distal to giant calcified aneurysms that were regarded as false positive findings, and were identified as mild stenoses by CAG.


CONCLUSIONS
MSCT offers advantages over CAG in the evaluation of calcified aneurysms and intimal hypertrophy, and is a potential diagnostic modality for coronary intervention in patients after Kawasaki disease.
Department of Pediatrics and Childhealth, Nihon University School of Medicine, Tokyo. hkin@med.nihon-u.ac.jp
Hiroshi
H
Kanamaru
Kensuke
K
Karasawa
Rie
R
Ichikawa
Osamu
O
Abe
Michio
M
Miyashita
Kazuo
K
Taniguchi
Mamoru
M
Ayusawa
Naokata
N
Sumitomo
Tomoo
T
Okada
Tadateru
T
Takayama
Yuichi
Y
Sato
Satoshi
S
Saito
Kensuke
K
Harada
D000293:Adolescent; D000328:Adult; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D003323:Coronary Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods