[Disorders of myocardial perfusion in Kawasaki syndrome: noninvasive detection by 201 thallium tomography].

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.