TY - JOUR
T1 - CT Angiography or Cardiac MRI for Detection of Coronary Artery Aneurysms in Kawasaki Disease
AU - van Stijn-Bringas Dimitriades, Diana
AU - Planken, Nils
AU - Kuipers, Irene
AU - Kuijpers, Taco
N1 - Funding Information: We are grateful to Dr. M. van den Hof for statistical advice. Funding. The funding was made available by the foundation Kind en Handicap and an anonymous donor through the AMC foundation. Publisher Copyright: © Copyright © 2021 van Stijn-Bringas Dimitriades, Planken, Kuipers and Kuijpers.
PY - 2021/2/4
Y1 - 2021/2/4
N2 - Background: Kawasaki disease (KD) is an acute vasculitis that mainly affects the coronary arteries. This inflammation can cause coronary artery aneurysms (CAAs). Patients with KD need cardiac assessment for risk stratification for the development of myocardial ischemia, based on Z-score (luminal diameter of the coronary artery corrected for body surface area). Echocardiography is the primary imaging modality in KD but has several important limitations. Coronary computed tomographic angiography (cCTA) and Cardiac MRI (CMR) are non-invasive imaging modalities and of additional value for assessment of CAAs with a high diagnostic yield. The objective of this single center, retrospective study is to explore the diagnostic potential of coronary artery assessment of cCTA vs. CMR in children with KD. Methods and Results: Out of 965 KD patients from our database, a total of 111 cCTAs (104 patients) and 311 CMR (225 patients) have been performed since 2010. For comparison, we identified 54 KD patients who had undergone both cCTA and CMR. CMR only identified eight patients with CAAs compared to 14 patients by cCTA. CMR missed 50% of the CAAs identified by cCTA. Conclusions: Our single center study demonstrates that cCTA may be a more sensitive diagnostic tool to detect CAAs in KD patients, compared to CMR.
AB - Background: Kawasaki disease (KD) is an acute vasculitis that mainly affects the coronary arteries. This inflammation can cause coronary artery aneurysms (CAAs). Patients with KD need cardiac assessment for risk stratification for the development of myocardial ischemia, based on Z-score (luminal diameter of the coronary artery corrected for body surface area). Echocardiography is the primary imaging modality in KD but has several important limitations. Coronary computed tomographic angiography (cCTA) and Cardiac MRI (CMR) are non-invasive imaging modalities and of additional value for assessment of CAAs with a high diagnostic yield. The objective of this single center, retrospective study is to explore the diagnostic potential of coronary artery assessment of cCTA vs. CMR in children with KD. Methods and Results: Out of 965 KD patients from our database, a total of 111 cCTAs (104 patients) and 311 CMR (225 patients) have been performed since 2010. For comparison, we identified 54 KD patients who had undergone both cCTA and CMR. CMR only identified eight patients with CAAs compared to 14 patients by cCTA. CMR missed 50% of the CAAs identified by cCTA. Conclusions: Our single center study demonstrates that cCTA may be a more sensitive diagnostic tool to detect CAAs in KD patients, compared to CMR.
KW - Kawasaki disease
KW - cardiac MRI
KW - coronary artery aneurysms
KW - coronary artery assessment
KW - coronary computed tomographic angiography
KW - imaging
UR - http://www.scopus.com/inward/record.url?scp=85101093479&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fped.2021.630462
DO - https://doi.org/10.3389/fped.2021.630462
M3 - Article
C2 - 33614558
SN - 2296-2360
VL - 9
JO - Frontiers in pediatrics
JF - Frontiers in pediatrics
M1 - 630462
ER -