title: Assessment of coronary ischaemia by myocardial perfusion dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography, and coronary angiography in children with Kawasaki disease: pre- and post-coronary bypass grafting.
abstract: BACKGROUND
  Coronary artery lesions in Kawasaki disease invasively assessed by coronary angiography. Evaluation of myocardial perfusion by single-photon emission computed tomography may identify the haemodynamic significance of coronary lesions.
  
  
  OBJECTIVE
  To evaluate diagnostic accuracy of dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography as a possible alternative to invasive coronary angiography for detection and follow-up of myocardial ischaemia in patients with Kawasaki disease, and pre- and post-coronary bypass grafting.
  
  
  METHODS
  Coronary angiography and single-photon emission computed tomography were performed on 21 patients who were classified into three groups - group I (stenosis), group II (giant aneurysms), and group III (small aneurysms). Of the 21 patients, 16 (groups I and II) patients with myocardial perfusion defects, who underwent coronary bypass grafting, were followed up with single-photon emission computed tomography.
  
  
  RESULTS
  In group I, all patients had significant coronary stenosis and 100% of them had perfusion defects in the anterior and septal walls. In group II, all patients had giant aneurysms and 83% of them had inferior and inferolateral perfusion defects. In group III, all patients had small aneurysms and 100% of them had normal perfusion. Pre-coronary bypass grafting myocardial ischaemic defects disappeared in all patients after surgery. Sensitivity, specificity, and accuracy of single-photon emission computed tomography were 94, 100, and 95%, respectively.
  
  
  CONCLUSIONS
  Technetium-99 m tetrofosmin single-photon emission computed tomography can be applied as an accurate non-invasive diagnostic technique for detecting myocardial perfusion defects with coronary artery lesions, and to show improved or even normalised perfusion of the myocardium in patients after surgical revascularisation.
authors.affiliation: 1Department of Nuclear medicine,Assiut University,Egypt.
authors.forename: Mostafa S
authors.initials: MS
authors.lastname: Mostafa
authors.affiliation: 2Department of Pediatrics,Children and Women's University Hospital,Minia University,P.O. Box 61519,El-Minia,Egypt.
authors.forename: Ashraf O
authors.initials: AO
authors.lastname: Sayed
authors.affiliation: 3Department of Nuclear Medicine,Cairo University,Egypt.
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Al Said
mesh_terms: D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014665:Vasodilator Agents
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C078700:technetium tc-99m tetrofosmin; D004176:Dipyridamole
keywords: Kawasaki disease; coronary angiography; single-photon emission computed tomography