Pediatric Cardiology and Cardiac Surgery
Vol.27 No.1 2011 (35-42)
Tsutomu Kitatsume,1) Atsuko Suzuki,1) Atsushi Takemura,2) Tomoyoshi Sonobe,3) and Keiji Tsuchiya3)
Department of 1)Pediatrics, 2)Radiology, Tokyo Teishin Hospital, Tokyo, Japan3)Department of Pediatrics, Japan Red Cross Medical Center, Tokyo, Japan
Purpose: To investigate the intimal thickening of coronary arteries after Kawasaki disease, we measured the thickness of cross-sectional arterial walls by using MR imaging.
Method: The device was a commercial 1.5 Gyroscan Intera Master R9 with the newest sequence of 2D black-blood-spiral k-space order TFE. As the measurement sites, we chose the proximal segment of the right coronary artery, left main trunk, and the proximal segment of the left coronary artery.
Object: MR coronary angiography was performed in 65 patients with a history of Kawasaki disease (aged 11 months to 29 years).
Results: The thickness of the arterial wall was measured at the site of 46 regressed aneurysms, 14 sites that showed transient dilatation, and in 78 apparently normal coronary arteries that did not show any dilated lesions using two-dimensional echocardiography (2DE) after the acute stage of Kawasaki disease. We assessed all the lesions located at segments 1, 5, and 6, according to the American Heart Association classification; we also obtained corresponding measurements for normal coronary arteries. In children aged less than 14 years, no cross-sectional arterial wall was detected in 65 apparently normal coronary arteries, probably because these arteries were too thin to be detectable using MR imaging. However, cross-sectional arterial thickness was detected in 18 of the 38 regressed aneurismal walls and in 3 out of the 11 sites assessed after transient dilatation. There is no significant relationship between the thickness and the diameter of the aneurysms measured using 2DE in the acute phase.
Conclusion: The thickening of coronary artery walls was recognized in regressed aneurismal walls and post-transient dilatations using MR imaging.