Nienaber C A, Hausdorf G, Spielmann R P
UCLA School of Medicine, Dept. of Radiological Sciences.
Z Kardiol. 1988 Aug;77(8):503-7.
Myocardial infarction and stenotic coronary lesions are serious late complications in children with Kawasaki disease. For the noninvasive assessment of myocardial perfusion, dipyridamole-redistribution thallium-201 emission computed tomography (ECT) was performed in seven children (aged from 2 8/12 to 8 7/12 years) 3 to 20 months after the acute stage of the disease. In all patients, coronary aneurysms had been demonstrated by cross-sectional echocardiography. The scintigrams of six children showed no significant regional reduction of myocardial thallium-201 uptake. These children had remained asymptomatic since the acute stage of Kawasaki disease. Persistent and transient thallium-201 defects were present in one child with documented myocardial infarction. For this patient, obstructions of corresponding coronary vessels were confirmed by contrast angiography. It is suggested that thallium-201 ECT with dipyridamole-induced vasodilatation may be used as a safe alternative to invasive coronary angiography for detection of ischemia and follow-up investigations in patients with Kawasaki disease.
心肌梗死和冠状动脉狭窄性病变是川崎病患儿严重的晚期并发症。为了对心肌灌注进行无创评估，在7名患儿（年龄从2岁8个月至8岁7个月）疾病急性期后3至20个月进行了双嘧达莫-再分布铊-201发射计算机断层扫描（ECT）。所有患者均经横断面超声心动图证实有冠状动脉瘤。6名患儿的闪烁扫描图显示心肌铊-201摄取无明显区域减少。这些患儿自川崎病急性期以来一直无症状。1名有心肌梗死记录的患儿存在持续性和短暂性铊-201缺损。对于该患者，通过造影血管造影证实了相应冠状动脉血管的阻塞。提示双嘧达莫诱导血管扩张的铊-201 ECT可作为一种安全的替代方法，用于检测川崎病患者的缺血情况及进行随访研究，而无需进行有创冠状动脉造影。
