Ohmochi Y, Onouchi Z, Oda Y, Hamaoka K
Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
Coron Artery Dis. 1995 Jul;6(7):555-9.
Positron emission tomography and H2(15)O were used to characterize regional myocardial blood flow and distribution at rest and in response to dipyridamole in children with Kawasaki disease but without angiographic evidence of coronary stenosis.
Patients were classified into two groups on the basis of the results of selective coronary angiography: subjects in group I had normal coronary angiograms (n = 4): subjects in group II had aneurysms (n = 5).
Myocardial perfusion, assessed with H2(15)O, was homogeneous over all regions at rest and at peak flow in groups I and II. Dipyridamole infusion significantly reduced myocardial perfusion reserve in group II (average 3.56 +/- 1.03 fold versus 5.06 +/- 1.37 fold in group I, P < 0.001).
Our results suggest that aneurysms associated with Kawasaki disease may reduce myocardial reserve. Non-invasive quantitative assessment of myocardial blood flow with positron emission tomography and H2(15)O was useful in assessing the functional capacity of coronary artery lesions and the extent of myocardial damage in children with Kawasaki disease.
采用正电子发射断层扫描和H2(15)O对川崎病患儿静息及双嘧达莫激发状态下的局部心肌血流及分布情况进行了特征性研究，这些患儿无冠状动脉狭窄的血管造影证据。
根据选择性冠状动脉造影结果将患者分为两组：I组患者冠状动脉造影正常（n = 4）；II组患者有动脉瘤（n = 5）。
I组和II组在静息及血流峰值时，用H2(15)O评估的心肌灌注在所有区域均呈均匀分布。双嘧达莫输注使II组心肌灌注储备显著降低（平均为3.56±1.03倍，而I组为5.06±1.37倍，P<0.001）。
我们的结果提示，与川崎病相关的动脉瘤可能会降低心肌储备。正电子发射断层扫描和H2(15)O对心肌血流进行无创定量评估，有助于评估川崎病患儿冠状动脉病变的功能状态及心肌损伤程度。
