Spielmann R P, Nienaber C A, Hausdorf G, Montz R
Department of Nuclear Medicine, University Hospital, Hamburg, FRG.
J Nucl Med. 1987 Dec;28(12):1839-43.
Myocardial infarction and stenotic coronary lesions are serious late complications in children with Kawasaki disease. For the noninvasive assessment of myocardial perfusion, dipyridamole-redistribution 201Tl emission computed tomography (ECT) was performed in seven children (age 2 8/12-8 7/12 yr) 3-20 mo 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 uptake. These children had remained asymptomatic since the acute stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with documented myocardial infarction. For this patient, obstruction of corresponding coronary vessels was confirmed by contrast angiography. It is suggested, that 201Tl ECT after dipyridamole-induced vasodilation may be used as a safe alternative to invasive coronary angiography for 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2岁8/12 - 8岁7/12岁）疾病急性期后3 - 20个月进行了双嘧达莫 - 再分布201铊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摄取无明显区域性降低。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缺损。对于该患者，经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后的201铊ECT可作为川崎病患者随访调查中侵入性冠状动脉造影的安全替代方法。
