Department of Radiological, Onchological and Anatomopathological Sciences, Policlinico Umberto I, Sapienza University of Rome, viale Regina Elena, 324, Rome, 00161, Italy.
Pediatr Radiol. 2011 Sep;41(9):1165-73. doi: 10.1007/s00247-011-2141-0. Epub 2011 Jun 30.
Kawasaki disease (KD) is a systemic vasculitis that mainly affects coronary arteries in children, and requires regular follow-up from the time of diagnosis.
To evaluate the feasibility of 64-slice CT angiography (CTA) for follow-up of patients with KD using previously performed invasive catheter coronary angiography (CCA) as reference standard.
The study group comprised 12 patients (age 17.6 ± 2.9 years, mean ± SD) with a diagnosis of KD and a previously performed CCA (interval, 32.6 ± 13.5 months) who underwent 64-slice cardiac CTA. The quality of the images for establishing the presence of coronary abnormalities was determined by two observers. The CTA findings were compared with those from the prior CCA.
Adequate image quality was obtained in all patients. Mean effective dose for CTA was 6.56 ± 0.95 mSv. CTA allowed accurate identification, characterization and measurement of all coronary aneurysms (n = 32), stenoses (n = 3) and occlusions (n = 9) previously demonstrated by CCA. One patient with disease progression went on to have percutaneous coronary intervention.
Coronary lesions were reliably evaluated by 64-slice CTA in the follow-up of compliant patients with KD, reducing the need for repeated diagnostic invasive CCA. Hence, in an adequately selected patient population, the role of CCA could be limited almost only to therapeutic procedures.
川崎病（KD）是一种全身性血管炎，主要影响儿童的冠状动脉，需要从诊断时开始定期随访。
以先前进行的有创导管冠状动脉造影（CCA）为参考标准，评估 64 层 CT 血管造影（CTA）在 KD 患者随访中的可行性。
研究组包括 12 名患者（年龄 17.6±2.9 岁，均数±标准差），均诊断为 KD，且之前已行 CCA（间隔时间 32.6±13.5 个月），并接受 64 层心脏 CTA 检查。两名观察者评估建立冠状动脉异常存在的图像质量。将 CTA 结果与先前的 CCA 结果进行比较。
所有患者均获得了足够的图像质量。CTA 的平均有效剂量为 6.56±0.95 mSv。CTA 能够准确识别、描述和测量所有先前 CCA 显示的冠状动脉瘤（n=32）、狭窄（n=3）和闭塞（n=9）。1 例疾病进展的患者随后接受了经皮冠状动脉介入治疗。
在依从性良好的 KD 患者的随访中，64 层 CTA 可靠地评估了冠状动脉病变，减少了对重复有创性诊断性 CCA 的需求。因此，在选择合适的患者人群中，CCA 的作用几乎可以仅限于治疗性操作。
