title: Regional cerebral blood flow abnormalities in patients with kawasaki disease.
abstract: OBJECTIVE
  Kawasaki disease (KD) is an acute febrile disorder of unknown etiology. Brain single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) help in detecting regional cerebral blood flow abnormalities and brain damage. The usefulness of SPECT and MRI in patients with KD was evaluated.
  
  
  METHODS
  All 22 patients with KD underwent brain SPECT using Tc-99m-hexamethyl propylene amine oxime from 6 days to 3 years after onset, and 8 patients underwent brain MRI. Of the 22 patients, 4 had neurologic symptoms. Case 1 showed prolonged apnea; case 2, prolonged disturbance of consciousness; and cases 3 and 4 generalized tonic-clonic seizures. Initial brain SPECT showed localized hypoperfusion in 4 and 13 patients with and without neurologic symptoms, respectively.
  
  
  RESULTS
  All patients with neurologic symptoms underwent follow-up SPECT; localized hypoperfusion was detected between 1- and 6-month follow-up in 3 of these patients. Six patients without neurologic symptoms underwent follow-up SPECT. Localized hypoperfusion was detected at approximately 1- to 11-month follow-up in 4 of these patients. Diffusion-weighted imaging revealed abnormal high-intensity areas in the corpus callosum in case 1. Case 2 showed a bilateral chronic subdural hematoma with decreased size and ischemic changes, and case 3 showed bilateral hippocampal atrophy and left hippocampal sclerosis.
  
  
  CONCLUSIONS
  Because the occurrence of localized hypoperfusion is possibly not restricted to only the acute phase in KD, brain SPECT and MRI should also be performed in KD patients with neurologic symptoms.
authors.affiliation: Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hikita
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Kaminaga
authors.forename: Suguru
authors.initials: S
authors.lastname: Wakita
authors.forename: Kaori
authors.initials: K
authors.lastname: Ogita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ikemoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oba
authors.forename: Yukishige
authors.initials: Y
authors.lastname: Yanagawa
mesh_terms: D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon