BACKGROUND: After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. OBJECTIVE: To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. MATERIALS AND METHODS: A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). RESULTS: There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI-one stenosis was missed. CONCLUSION: MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS.
BACKGROUND: After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. OBJECTIVE: To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. MATERIALS AND METHODS: A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). RESULTS: There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI-one stenosis was missed. CONCLUSION: MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS.
Authors: S Achenbach; S Ulzheimer; U Baum; M Kachelriess; D Ropers; T Giesler; W Bautz; W G Daniel; W A Kalender; W Moshage Journal: Circulation Date: 2000-12-05 Impact factor: 29.690
Authors: Gerald F Greil; Matthias Stuber; René M Botnar; Kraig V Kissinger; Tal Geva; Jane W Newburger; Warren J Manning; Andrew J Powell Journal: Circulation Date: 2002-02-26 Impact factor: 29.690
Authors: H Kato; T Sugimura; T Akagi; N Sato; K Hashino; Y Maeno; T Kazue; G Eto; R Yamakawa Journal: Circulation Date: 1996-09-15 Impact factor: 29.690
Authors: Ahmed M Gharib; Roderic I Pettigrew; Abdalla Elagha; Amy Hsu; Pam Welch; Steven M Holland; Alexandra F Freeman Journal: AJR Am J Roentgenol Date: 2009-12 Impact factor: 3.959