title: Linear shadows inside coronary arterial lesions on two-dimensional echocardiograhpy in Kawasaki disease patients.
abstract: BACKGROUND
  Conventional two-dimensional echocardiography (2DE) is not adequately sensitive enough for the detection of stenotic or occlusive coronary lesions that occur in Kawasaki disease. Recently, linear shadows have been detected inside large- or moderate-sized coronary artery lesions (CALs) by high-resolution 2DE at a convalescent or chronic stage.
  
  
  OBJECTIVE
  We evaluated the clinical significance of the linear shadows detected by 2DE and compared the findings with those obtained using coronary angiography (CAG), magnetic resonance imaging (MRI), and intravascular ultrasound (IVUS).
  
  
  RESULTS
  From December 2001 to November 2006, linear shadows were detected in 11 out of 18 CALs in 9 patients at our institution. The outer diameters of the CALs by 2DE were larger than the diameters of CALs by CAG, while the inner diameters between the linear shadows by 2DE correlate with the diameters of CALs by CAG. Remarkably thickened intima was confirmed in 7 out of 9 CALs by MRI, and in every lesion that was examined using IVUS.
  
  
  CONCLUSIONS
  The results of this study suggest that linear shadows by 2DE would indicate the existence of a thickened intima. We consider that linear shadows may be useful to estimate the development of stenotic lesions during the process of regression or remodeling of CALs.
authors.affiliation: Department of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. ahamaoka@koto.kpu-m.ac.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Hamaoka
authors.forename: Ayumi
authors.initials: A
authors.lastname: Niboshi
authors.forename: Sei-ichiro
authors.initials: S
authors.lastname: Ozawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamiya
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ito
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itoi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hamaoka
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004452:Echocardiography; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional