van Stijn Diana, Planken Nils, Kuipers Irene, Kuijpers Taco
Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands.
Front Pediatr. 2021 Feb 4;9:630462. doi: 10.3389/fped.2021.630462. eCollection 2021.
Kawasaki disease (KD) is an acute vasculitis that mainly affects the coronary arteries. This inflammation can cause coronary artery aneurysms (CAAs). Patients with KD need cardiac assessment for risk stratification for the development of myocardial ischemia, based on score (luminal diameter of the coronary artery corrected for body surface area). Echocardiography is the primary imaging modality in KD but has several important limitations. Coronary computed tomographic angiography (cCTA) and Cardiac MRI (CMR) are non-invasive imaging modalities and of additional value for assessment of CAAs with a high diagnostic yield. The objective of this single center, retrospective study is to explore the diagnostic potential of coronary artery assessment of cCTA vs. CMR in children with KD. Out of 965 KD patients from our database, a total of 111 cCTAs (104 patients) and 311 CMR (225 patients) have been performed since 2010. For comparison, we identified 54 KD patients who had undergone both cCTA and CMR. CMR only identified eight patients with CAAs compared to 14 patients by cCTA. CMR missed 50% of the CAAs identified by cCTA. Our single center study demonstrates that cCTA may be a more sensitive diagnostic tool to detect CAAs in KD patients, compared to CMR.
川崎病（KD）是一种主要影响冠状动脉的急性血管炎。这种炎症可导致冠状动脉瘤（CAA）。KD患者需要进行心脏评估，以便根据评分（校正体表面积后的冠状动脉管腔直径）对心肌缺血发生风险进行分层。超声心动图是KD的主要影像学检查方法，但有几个重要局限性。冠状动脉计算机断层血管造影（cCTA）和心脏磁共振成像（CMR）是非侵入性成像方法，对CAA评估具有额外价值，诊断率高。这项单中心回顾性研究的目的是探讨cCTA与CMR对KD患儿冠状动脉评估的诊断潜力。自2010年以来，在我们数据库的965例KD患者中，共进行了111次cCTA检查（104例患者）和311次CMR检查（225例患者）。为了进行比较，我们确定了54例同时接受cCTA和CMR检查的KD患者。CMR仅识别出8例CAA患者，而cCTA识别出14例。CMR漏诊了cCTA识别出的50%的CAA。我们的单中心研究表明，与CMR相比，cCTA可能是检测KD患者CAA更敏感的诊断工具。
