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Magnetic resonance coronary angiography to evaluate coronary arterial lesions in patients with Kawasaki disease

Published online by Cambridge University Press:  20 November 2006

Atsuko Suzuki ,
Atsushi Takemura ,
Rikako Inaba ,
Tomoyoshi Sonobe ,
Keiji Tsuchiya  and
Tateo Korenaga
Atsuko Suzuki
Affiliation:
Department of Pediatrics, Tokyo Postal Services Agency Hospital, Tokyo, Japan
Atsushi Takemura
Affiliation:
Department of Radiology, Tokyo Postal Services Agency Hospital, Tokyo, Japan
Rikako Inaba
Affiliation:
Department of Pediatrics, Tokyo Postal Services Agency Hospital, Tokyo, Japan
Tomoyoshi Sonobe
Affiliation:
Department of Pediatrics, Japan Red Cross Medical Center, Tokyo, Japan
Keiji Tsuchiya
Affiliation:
Department of Pediatrics, Japan Red Cross Medical Center, Tokyo, Japan
Tateo Korenaga
Affiliation:
Department of Radiology, Tokyo Postal Services Agency Hospital, Tokyo, Japan
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Abstract

We evaluated the efficiency of non-invasive magnetic resonance coronary angiography in detecting coronary arterial lesions in 106 patients, aged from 4 months to 37 years, with a median of 13 years, with Kawasaki disease. Non-contrast enhanced, free-breathing magnetic resonance coronary angiographic studies using both the steady-state free precession technique, namely bright blood imaging, and navigator-echo proton density weighted black blood imaging, so-called black blood imaging, were performed in all the patients. Conventional X-ray coronary angiography was performed in 70 patients with coronary arterial lesions.

We observed 97 aneurysms, 17 dilatations, 17 occlusions, 18 localized stenoses and 10 recanalized vessels, and we clarified their unique pattern of images on magnetic resonance coronary angiography. The differences in size of the aneurysms as seen on X-ray coronary angiography and bright blood imaging was mean 0.0, and the 95% confidence interval was from −1.4 to 1.5 on the Bland-Altman plots. With bright blood imaging, the sensitivity of occlusion and localized stenosis based on X-ray angiography was 94.2% and 97.2%, specificity was 99.5% and 97.2%, and negative-predictive value was 99.5% and 97.2%, respectively. Black blood imaging provided remarkable visualization of the thickened intima of aneurysms, and/or thrombus, in 38 lesions. We conclude that magnetic resonance coronary angiography can visualize all types of lesions due to Kawasaki disease in patients of all ages, and that it is useful to reduce the number of times X-ray angiography needs to be performed in patients with Kawasaki disease.

Keywords

Thrombusintimal thickeningcoronary aneurysms
Type
Original Article
Information
Cardiology in the Young , Volume 16 , Issue 6 , December 2006 , pp. 563 - 571
Copyright
© 2006 Cambridge University Press

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