Mavrogeni Sophie, Papadopoulos George, Douskou Marouso, Kaklis Savas, Seimenis Ioannis, Baras Panagiotis, Nikolaidou Polixeni, Bakoula Chryssa, Karanasios Evangelos, Manginas Athanasios, Cokkinos Dennis V
Onassis Cardiac Surgery Center, Athens, Greece.
J Am Coll Cardiol. 2004 Feb 18;43(4):649-52. doi: 10.1016/j.jacc.2003.08.052.
The purpose of this study was to compare the results of magnetic resonance angiography (MRA) with X-ray coronary angiography (XCA) in a pediatric population.
Coronary artery abnormalities in Kawasaki disease (KD) develop in about 15% to 25% of young patients, mostly in the form of aneurysms.
Thirteen patients (12 male), age three to eight years, were studied. The maximal diameter and length of the aneurysm were recorded. Coronary MRA was performed using a 1.5 T Philips Intera CV magnetic resonance scanner with an electrocardiographically triggered pulse sequence. It was a three-dimensional segmented k-space gradient-echo sequence (TE = 2.1 ms, TR = 7.5 ms, flip angle = 30 degrees, slice thickness = 1.5 mm) employing a T2-weighted preparation pre-pulse and a frequency selective fat-saturation pre-pulse. Data acquisition was performed in mid-diastole. All scans were carried out with the patient free breathing using a two-dimensional real-time navigator beam. All patients underwent XCA within a week.
In six patients, aneurysms of the coronary arteries were identified, while coronary ectasia alone was present in the remaining seven patients. Magnetic resonance angiography and XCA diagnosis of coronary artery aneurysm agreed completely. Maximal aneurysm diameter and length and ectasia diameter by MRA and XCA were similar. No stenotic lesion was identified by either technique.
In conclusion, MRA is a reliable diagnostic tool, equivalent to XCA for coronary artery aneurysm identification in patients with KD. Magnetic resonance angiography may prove to be of great value for the serial non-invasive evaluation of these patients.
本研究旨在比较磁共振血管造影（MRA）与X线冠状动脉造影（XCA）在儿科人群中的结果。
川崎病（KD）患者中约15%至25%的年轻患者会出现冠状动脉异常，多数表现为动脉瘤形式。
对13例年龄3至8岁的患者（12例男性）进行研究。记录动脉瘤的最大直径和长度。使用1.5T飞利浦Intera CV磁共振扫描仪及心电图触发脉冲序列进行冠状动脉MRA检查。采用三维分段k空间梯度回波序列（TE = 2.1毫秒，TR = 7.5毫秒，翻转角 = 30度，层厚 = 1.5毫米），并使用T2加权准备预脉冲和频率选择性脂肪饱和预脉冲。在舒张中期进行数据采集。所有扫描均在患者自由呼吸状态下使用二维实时导航波束进行。所有患者在一周内接受了XCA检查。
6例患者发现冠状动脉动脉瘤，其余7例患者仅存在冠状动脉扩张。MRA和XCA对冠状动脉动脉瘤的诊断完全一致。MRA和XCA测得的动脉瘤最大直径、长度及扩张直径相似。两种技术均未发现狭窄病变。
总之，MRA是一种可靠的诊断工具，在识别KD患者冠状动脉动脉瘤方面与XCA相当。磁共振血管造影可能对这些患者的系列无创评估具有重要价值。
