Pediatric Heart Disease
Haruki Nonaka, RT
Radiologist
Tsuchiya General Hospital, Japan
Haruki Nonaka, RT
Radiologist
Tsuchiya General Hospital, Japan
Masahiro Tahara, MD
Head physician
Hiroshima central street Children’s Clinic, Japan
Kazuya Sanada, MD
Head physician
Shizuoka Children's Hospital
Shizuoka City, Japan
Mio Okano, RT
Radiologist
Tsuchiya General Hospital, Japan
Yuko Morikawa
RT
Tsuchiya General Hospital, Japan
Tetsuya Nitta, MD
Dr
Nitta Pediatric Clinic, Japan
Masami Yoneyama
MT
Philips Japan, Japan
Takayuki Yoshiura
RT
Tsuchiya General Hospital, Japan
Naoyuki Imada
RT
North Hiroshima Hospital, Japan
Tomoyasu Sato, MD, PhD
Head Physician
Tsuchiya Genaral Hospital, Japan
Kawasaki disease (KD) is a systemic vasculitis in approximately 2% of untreated patients; this syndrome can also cause systemic artery aneurysms (SAAs)[1]. In addition, there are a few reports of neurological complications in patients with KD[2][3]. This study aimed to investigate the feasibility and usefulness of evaluating coronary aneurysms, SAAs, and cerebrovascular disease in patients with KD by one examination using non-contrast magnetic resonance angiography (NC-MRA).
Methods: Eighty-nine examinations of 44 patients who underwent non-contrast coronary MRA in our hospital between June 2016 and March 2022 were identified. Forty-nine (3 - 23, mean 10.8 ±5.4 years) examinations of 28 patients underwent coronary artery protocol including coronary MRA and vessel wall imaging, 40 (0 - 33, 10.7 ± 7.2 mean years) examinations of 40 patients underwent systemic artery protocol including SAAs scan and head MRA, in addition to coronary artery protocol. Then, the image qualities of the coronary MRA and vessel wall imaging were evaluated to visualize a 4-point scale (4 = excellent, 3 = good, 2 = acceptable, 1 = unacceptable). The qualities and examination time, and dose of sedation were compared between the two protocols. In addition, the presence of SAAs and cerebrovascular disease were evaluated.
Results:
There was no significant difference in the coronary MRA image (RCA: p=0.61, LMT: p=0.71, LAD: p=0.11, LCX: p=0.64) and vessel wall image (RCA: p=0.29, LMT: p=0.07, LAD: p=0.54, LCX: p=0.09), qualities score and examination time (50.0 [42.0-62.0] min vs. 51.0 [44.3-59.3] min, p=0.67) and sedative dose (4.69 [interquartile range 4.08-5.82] mg/kg vs. 4.21 [interquartile range 3.51-5.83] mg/kg, p=0.29) between coronary protocol and systemic artery protocol. Systemic artery protocol detected SAAs in 3 of 40 patients (7.5%); two patients with bilateral brachial artery aneurysms, one with a right brachial artery aneurysm, and cerebrovascular disease were not detected.
Conclusion:
Evaluation of coronary artery and systemic artery in patients with KD by N-C MRA on a single examination was possible without compromising image quality, examination time, and sedation dose compared with conventional coronary MRA examination. This protocol was useful for finding SAAs.