From the Departments of Radiology (Y.T., T.K.) and Cardiology (M.M.), Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., M.J.); Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (A.H.); Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (A.H.); Center for Intractable Diseases, Saitama University Hospital, Saitama, Japan (G.N.); Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan (K.Y.); Department of Radiology, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan (K.S.); Department of Neurology, Chiba University School of Medicine, Chiba, Japan (H.H.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (S.N.).
Radiographics. 2022 Jan-Feb;42(1):268-288. doi: 10.1148/rg.210070. Epub 2021 Nov 26.
Kawasaki disease (KD) is a common pediatric vasculitis syndrome involving medium- and small-sized arteries that is especially prevalent in early childhood (ie, age 6 months to 5 years). The diagnosis of KD is made on the basis of clinical features, such as fever, characteristic mucocutaneous changes, and nonsuppurative cervical lymphadenopathy. However, early diagnosis is often challenging because many children with KD present with atypical symptoms. The most serious complication of KD is coronary artery aneurysm caused by coronary arteritis. Prompt intravenous immunoglobulin therapy reduces the risk of cardiac morbidity. In addition, the systemic extension of KD-related vasculitis during the acute phase causes a variety of multisystem manifestations, including encephalopathy, stroke, retropharyngeal edema, pericarditis, myocarditis, KD shock syndrome, pulmonary lesions, intestinal pseudo-obstruction, gallbladder hydrops, arthritis, and myositis. These complications tend to be more common in affected children with atypical presentation. Radiologists can play an important role in the timely identification of diverse KD-associated morbidities and thus may contribute to the early diagnosis of atypical KD. RSNA, 2021.
川崎病(KD)是一种常见的儿科血管炎综合征,涉及中、小动脉,尤其多见于幼儿(即 6 个月至 5 岁)。KD 的诊断基于临床特征,如发热、特征性黏膜皮肤改变和非化脓性颈淋巴结肿大。然而,早期诊断通常具有挑战性,因为许多 KD 患儿表现为不典型症状。KD 最严重的并发症是由冠状动脉炎引起的冠状动脉瘤。及时静脉注射免疫球蛋白治疗可降低心脏发病率的风险。此外,急性期中 KD 相关血管炎的全身扩散会导致多种多系统表现,包括脑病、中风、咽后水肿、心包炎、心肌炎、KD 休克综合征、肺部病变、假性肠梗阻、胆囊积水、关节炎和肌炎。这些并发症在表现不典型的患儿中更为常见。放射科医生可以在及时识别各种 KD 相关疾病方面发挥重要作用,从而有助于早期诊断不典型 KD。RSNA,2021 年。