awasaki disease (KD) is an acute vasculitis of unknown origin that predominantly occurs in young children. It is associated with coronary artery aneurysms (CAA) in approximately 15-25% of untreated cases. 1,2 Rupture and acute thrombosis may occur in the acute phase of illness, but occur rarely in adolescents and young adults. 2 However, approximately 4% of cases subsequently develop stenotic lesions that lead to sudden death from myocardial infarction in adulthood. 2 Serial assessment of the status of the coronary arteries is therefore essential for the management of patients with KD, but evaluation with coronary angiography (CAG) carries risk because of its invasive nature, 3 and it is expensive. Multislice spiral computed tomography (MSCT) has brought a new era of coronary artery imaging because it enables noninvasive visualization of the entire coronary artery system. MSCT can detect obstructive coronary artery disease [4][5][6] and coronary artery plaques. 7 We describe the efficacy of MSCT for detecting coronary artery abnormalities in 4 adolescents with KD.
Multislice spiral computed tomography (MSCT) permits direct visualization of not only coronary artery stenosis but also atherosclerotic plaques in patients with coronary artery disease. In this report, we describe a patient with stable angina in whom the regression of the plaque was documented by serial MSCT examinations. In the patient, a 46-year-old man with stable angina, MSCT revealed a stenotic lesion at the proximal portion of the left anterior descending artery. Axial, curved multiplanar reconstruction and cross-sectional images consistently depicted a protruding computed tomography low-signal mass suggesting an atherosclerotic plaque. Intracoronary ultrasound (ICUS) also documented an eccentric soft plaque with an echo-lucent mass suggesting a lipid core. Lipid-lowering therapy with pravastatin was started. Follow-up MSCT performed 7 months later documented an increase in the luminal area while the external vessel area remained unchanged. The regression of the plaque was also confirmed by a follow-up ICUS study. MSCT was thought to be feasible for serial evaluation of the plaque size and texture.
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