title: Coronary artery abnormalities in Kawasaki disease: comparison between CT and MR coronary angiography.
abstract: BACKGROUND
  Although CT coronary angiography (CTCA) and MR coronary angiography (MRCA) are increasingly used in patients with Kawasaki disease, comparison of coronary artery assessibility and diagnostic performance between the two imaging modalities has been rarely performed.
  
  
  OBJECTIVE
  To investigate which imaging modality, CTCA or MRCA, is better for evaluating coronary artery abnormalities in patients with Kawasaki disease.
  
  
  METHODS
  Between 2003 and 2011, 56 patients (38 boys/men; age range, 1-24 years) with Kawasaki disease underwent CTCA or MRCA (group A). Of these, 17 underwent both CTCA and MRCA (group B). Visibility of 11 coronary arterial segments in each patient was graded on a four-point scale. Coronary artery aneurysm, stenosis, and occlusion were evaluated by CTCA and MRCA, based on a reference standard obtained from cardiac catheterization, echocardiography, follow-up CTCA and MRCA, and clinical history. Coronary artery assessibility and diagnostic performance were compared between CTCA and MRCA.
  
  
  RESULTS
  In per-segment analysis, more segments were assessable on CTCA than on MRCA in both groups. In per-patient analysis of group B, no significant difference in the assessibility was found between CTCA (95.0%, 128.3/135 segments) and MRCA (92.4%, 124.8/135 segments) (P > 0.05). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTCA vs. MRCA were 93.1% vs. 77.9% (P < 0.001), 99.2% vs. 99.7% (P = 0.65), 96.8% vs. 98.7% (P = 0.65), 98.2% vs. 94.1% (P < 0.001), and 98.0% vs. 94.9% (P = 0.008), respectively, in group A, and 91.8% vs. 70.4% (P < 0.001), 99.5% vs. 99.5% (P = 1.000), 98.5% vs. 98.0% (P = 1.000), 97.2% vs. 91.1% (P = 0.006), and 97.6% vs. 92.3% (P = 0.004), respectively, in group B.
  
  
  CONCLUSIONS
  Although CTCA and MRCA show comparable assessibility in per-patient analysis, CTCA shows higher diagnostic performance than MRCA for evaluating coronary artery abnormalities in patients with Kawasaki disease.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Goo
mesh_terms: D000293:Adolescent; D055424:Cardiac-Gated Imaging Techniques; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D007479:Iopamidol / Q000031:analogs & derivatives; D018810:Magnetic Resonance Angiography; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol