Computed Tomography Coronary Angiography for Evaluation of Children With Kawasaki Disease

Publication date: July–August 2018

Source: Current Problems in Diagnostic Radiology, Volume 47, Issue 4

Author(s): Manphool Singhal, Surjit Singh, Pankaj Gupta, Avinash Sharma, Niranjan Khandelwal, Jane C. Burns

Objective

We sought to assess the feasibility of computed tomography coronary angiography (CTCA) on a 128-slice, dual source scanner in children with acute and convalescent phase Kawasaki disease (KD).

Materials and Methods

A prospective study of 49 children with KD (12 at presentation and 37 in the convalescent phase) was conducted between November 2013 and April 2015. CTCA was performed with either prospective (n = 37) or retrospective (n = 12) electrocardiographic gating. A radiologist blinded to clinical profile and echocardiogram evaluated each scan.

Results

Median age (36 boys and 13 girls) was 7 years. Median dose-length product value and median effective CT radiation dose was 32 mGy cm (interquartile range [IQR]: 21-74) and 0.54 miliSieverts (mSv) (IQR: 0.77-3.2) for all scans, and 27 mGy cm (IQR: 18.5-33.75) and 0.48 mSv (IQR: 0.18-1.17) for prospectively triggered scans (n = 37). Fourteen subjects (30 coronary segments) showed abnormalities by CTCA including aneurysms (n = 27) and stenoses (n = 3). In the acute phase (n = 12), aneurysms were detected in 5 children (18 segments).

Conclusion

CTCA allows comprehensive evaluation of coronary arteries in children with KD.

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