计算机断层扫描冠状动脉造影术用于评估川崎病患儿
Computed Tomography Coronary Angiography for Evaluation of Children With Kawasaki Disease.
作者信息
Singhal Manphool, Singh Surjit, Gupta Pankaj, Sharma Avinash, Khandelwal Niranjan, Burns Jane C
机构信息
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Curr Probl Diagn Radiol. 2018 Jul-Aug;47(4):238-244. doi: 10.1067/j.cpradiol.2017.09.013. Epub 2017 Oct 23.
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 32mGycm (interquartile range [IQR]: 21-74) and 0.54 miliSieverts (mSv) (IQR: 0.77-3.2) for all scans, and 27mGycm (IQR: 18.5-33.75) and 0.48mSv (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.
目的
我们旨在评估在128层双源扫描仪上对急性和恢复期川崎病（KD）患儿进行计算机断层扫描冠状动脉造影（CTCA）的可行性。
材料与方法
2013年11月至2015年4月对49例KD患儿（12例处于急性期，37例处于恢复期）进行了一项前瞻性研究。CTCA采用前瞻性（n = 37）或回顾性（n = 12）心电图门控技术进行。一名对临床资料和超声心动图结果不知情的放射科医生对每次扫描进行评估。
结果
患儿中位年龄为7岁（36例男孩，13例女孩）。所有扫描的中位剂量长度乘积值和中位有效CT辐射剂量分别为32mGycm（四分位间距[IQR]：21 - 74）和0.54毫西弗（mSv）（IQR：0.77 - 3.2），前瞻性触发扫描（n = 37）的分别为27mGycm（IQR：18.5 - 33.75）和0.48mSv（IQR：0.18 - 1.17）。14名受试者（30个冠状动脉节段）通过CTCA显示异常，包括动脉瘤（n = 27）和狭窄（n = 3）。在急性期（n = 12），5名患儿（18个节段）检测到动脉瘤。
结论
CTCA能够对KD患儿的冠状动脉进行全面评估。
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