Chan Yan Hei, Young Catherine Yee Man, Wang Ki, So Enoch C T, Chu Winnie C W
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
BJR Case Rep. 2023 Dec 18;10(1):uaad008. doi: 10.1093/bjrcr/uaad008. eCollection 2024 Jan.
Kawasaki disease is the most common vasculitis causing acquired coronary artery aneurysm (CAA) and affects mostly children. Computed tomography coronary angiography (CTCA) has unique diagnostic and prognostic values in cases of giant CAA. Here, we report technical challenges encountered when performed CTCA for a case of Kawasaki disease complicated with giant CAA. In particular, there was significant flow alteration caused by the giant CAA(s) causing suboptimal enhancement when the standard protocol was applied. We share our experience in optimizing the scan and propose the use of either manual bolus tracking or test bolus technique in similar scenarios, as well as multidisciplinary approach to optimize patient preparation.
川崎病是导致获得性冠状动脉瘤（CAA）的最常见血管炎，主要影响儿童。计算机断层扫描冠状动脉造影（CTCA）在巨大CAA病例中具有独特的诊断和预后价值。在此，我们报告了对一例川崎病合并巨大CAA患者进行CTCA时遇到的技术挑战。特别是，巨大CAA导致显著的血流改变，在应用标准方案时导致强化不佳。我们分享了优化扫描的经验，并建议在类似情况下使用手动团注追踪或试验团注技术，以及采用多学科方法优化患者准备。
