Kondo C, Nakanishi T, Sonobe T, Tatara K, Momma K, Kusakabe K
Department of Pediatric Cardiology, Daini Hospital, Tokyo Women's Medical College, Japan.
Am J Cardiol. 1993 Mar 15;71(8):681-5. doi: 10.1016/0002-9149(93)91010-f.
Noninvasive monitoring of the process of coronary occlusion will probably aid in determining the timing of therapeutic interventions for Kawasaki disease. A pair study of coronary angiography and thallium scintigraphy after dipyridamole infusion-single-photon emission computed tomography with dipyridamole infusion (Dp-SPECT) was repeated at least twice at intervals of several years in 29 patients, and these findings were compared and analyzed in a chronologic manner. The current study demonstrated that angiographic stenosis was more severe, with an increase in the severity of the perfusion defect. Positive rates determined by Dp-SPECT increased with increasing severity of stenosis on angiography. Angiographic findings from the first to the second serial study that showed worsening, no change and improvement were correctly diagnosed from scintigraphic changes in 94% of coronary arterial lesions. About half of the arteries with progression in stenotic severity could be found before complete occlusion by scintigraphic monitoring. It is concluded that Dp-SPECT can be used as a noninvasive monitor of the occurrence and progression of coronary stenoses due to Kawasaki disease.
对冠状动脉闭塞过程进行无创监测可能有助于确定川崎病治疗干预的时机。对29例患者每隔数年重复进行至少两次双嘧达莫负荷试验-单光子发射计算机断层扫描（Dp-SPECT）后的冠状动脉造影和铊闪烁扫描配对研究，并按时间顺序对这些结果进行比较和分析。当前研究表明，血管造影狭窄更严重，灌注缺损的严重程度增加。Dp-SPECT测定的阳性率随血管造影狭窄严重程度的增加而升高。在94%的冠状动脉病变中，通过闪烁扫描变化可正确诊断出首次至第二次系列研究中血管造影结果显示恶化、无变化和改善的情况。通过闪烁扫描监测，约一半狭窄严重程度进展的动脉在完全闭塞前就能被发现。结论是，Dp-SPECT可作为川崎病所致冠状动脉狭窄发生和进展的无创监测手段。
