Capannari T E, Daniels S R, Meyer R A, Schwartz D C, Kaplan S
J Am Coll Cardiol. 1986 Feb;7(2):355-60. doi: 10.1016/s0735-1097(86)80505-8.
Seventy-seven patients with Kawasaki disease were prospectively evaluated from 1978 to 1983 to determine the sensitivity, specificity and predictive value for detecting coronary artery aneurysms with two-dimensional echocardiography. Seventy (91%) underwent selective coronary arteriography and are included in this report. The study was divided into two periods because of increased experience and the use of a systematic approach with two-dimensional echocardiography in the second period as compared with the first. Aneurysms were demonstrated in nine patients (13%). The coronary artery system was divided into six regions: proximal third of the main right coronary artery, distal right coronary artery, left main coronary artery, left anterior descending coronary artery, circumflex coronary artery and distal left coronary artery. The sensitivity and specificity were high when imaging the proximal regions, and improved from the first period to the second. Both sensitivity and specificity were lower for the more distal regions of the right and left coronary arteries. Overall, the sensitivity of two-dimensional echocardiography was 100% because there were no patients in our study who had isolated distal coronary artery aneurysms. Two-dimensional echocardiography is a sensitive and specific test for detecting aneurysms in the proximal portions of both the right and left coronary arteries, and is useful in selecting patients for invasive investigation with selective coronary arteriography.
1978年至1983年，对77例川崎病患者进行了前瞻性评估，以确定二维超声心动图检测冠状动脉瘤的敏感性、特异性和预测价值。其中70例（91%）接受了选择性冠状动脉造影，并纳入本报告。由于经验增加以及与第一阶段相比，第二阶段采用了二维超声心动图的系统方法，该研究分为两个阶段。9例患者（13%）发现有动脉瘤。冠状动脉系统分为六个区域：右冠状动脉主干近端三分之一、右冠状动脉远端、左冠状动脉主干、左冠状动脉前降支、左旋支冠状动脉和左冠状动脉远端。对近端区域成像时，敏感性和特异性较高，且从第一阶段到第二阶段有所提高。右冠状动脉和左冠状动脉更远端区域的敏感性和特异性均较低。总体而言，二维超声心动图的敏感性为100%，因为我们的研究中没有患者患有孤立的远端冠状动脉瘤。二维超声心动图是检测右冠状动脉和左冠状动脉近端动脉瘤的敏感且特异的检查方法，有助于选择进行选择性冠状动脉造影侵入性检查的患者。
