Muneuchi Jun, Kusuhara Koichi, Kanaya Yoshiaki, Ohno Takuro, Furuno Kenji, Kira Ryutaro, Mihara Futoshi, Hara Toshiro
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka 812-8582, Japan.
Brain Dev. 2006 Jan;28(1):30-3. doi: 10.1016/j.braindev.2005.04.003. Epub 2005 Jun 20.
We evaluated brain lesions in patients with coronary arterial lesions (CAL) as a complication of Kawasaki disease (KD) by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). Among 47 patients who underwent coronary angiography for the evaluation of CAL due to KD at Kyushu University Hospital from April 1996 to September 2004, 24 patients were evaluated prospectively by brain MRI and MRA 0.1-21.2 years after the onset of KD. Although most patients had irritability or lethargy, none of them had significant neurological symptoms or signs during the acute phase, except one who showed neck stiffness. In one patient with no apparent neurological symptoms out of the 24 patients, brain MRI and MRA revealed right cerebellar infarction and obliteration of the right posterior inferior cerebellar artery, respectively. These results revealed the presence of cerebrovascular lesion in one of the 24 KD patients with CAL and suggested the need to consider the possibility of brain lesions in severe cases of KD with or without neurological symptoms.
我们通过磁共振成像（MRI）和磁共振血管造影（MRA）评估了作为川崎病（KD）并发症的冠状动脉病变（CAL）患者的脑部病变。1996年4月至2004年9月期间，在九州大学医院因KD接受冠状动脉造影以评估CAL的47例患者中，24例患者在KD发病后0.1 - 21.2年接受了脑部MRI和MRA的前瞻性评估。尽管大多数患者有烦躁或嗜睡症状，但在急性期除1例表现为颈部强直外，均无明显的神经症状或体征。在这24例患者中，1例无明显神经症状的患者脑部MRI和MRA分别显示右小脑梗死和右小脑后下动脉闭塞。这些结果表明，在24例患有CAL的KD患者中有1例存在脑血管病变，并提示在有或无神经症状的重症KD病例中需要考虑脑部病变的可能性。
