Kawasaki Disease: Diagnosis and Follow-Up by CT Coronary Angiography with the Use of 128-Slice Dual Source Dual Energy Scanner. A Case Report

Ghareep, Abdel-Naser; Alkuwari, Maryam; Francis, Willington; Szmigielski, W

doi:10.12659/pjr.894680

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…However, CT angiography is being performed more frequently for diagnosis and follow-up of CAAs, including the evaluation of complications seen with KD [Figures 2 and 3 ]. [ 6 ] Aspirin and intravenous immunoglobulin have reduced morbidity associated with this disease. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

Coronary artery aneurysm in kawasaki disease

et al. 2020

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A 3-year-old male presents to the emergency department with chief complaints of fever and vomiting. He had a positive rapid streptococcus throat test with cervical lymphadenopathy. The patient was started on antibiotics. On examination, there was diffuse erythematous macular rash on the chest. Laboratory tests revealed elevated white cell count and C-reactive protein. Electrocardiogram was notable for prolonged PR interval indicating 1 st degree atrioventricular block. Echocardiogram revealed ectasia of the right coronary artery (RCA). A presumptive diagnosis of Kawasaki disease was made and the patient was started on high-dose aspirin and intravenous immunoglobulins. Cardiac computed tomography angiography (CTA) showed an aneurysm of the proximal RCA measuring up to 7.4 mm. The RCA immediately proximal to the aneurysm measured 3 mm in diameter. The Z score was 13.4. Oblique coronal image from cardiac CTA and volume rendered images demonstrated an aneurysm of the proximal RCA. The patient improved with treatment.

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Section: Discussionmentioning

confidence: 99%

Coronary artery aneurysm in kawasaki disease

et al. 2020

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“…Not to mention, coronary CTA eliminates the risk of procedural complications associated with invasive angiography and does not require hospitalization. Along with being time efficient, it is non‐invasive and allows for appropriate evaluation of the distal coronary vasculature 12 …”

Section: Discussionmentioning

confidence: 99%

“…Along with being time efficient, it is non-invasive and allows for appropriate evaluation of the distal coronary vasculature. 12 T A B L E 2 Comparison of pre-admission TTE findings and CTA findings…”

Section: Discussionmentioning

confidence: 99%

Giant coronary artery aneurysm in infantile Kawasaki disease: When to use cardiac computed tomography angiography

Kadakia

Do‐Nguyen

Kilcoyne

et al. 2020

Clinical Case Reports

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“…High-pitch low-dose CT angiography is an impressive alternative imaging modality for patients with AKD. CT angiography is free-breathing, does not require anesthesia and does not depend on the user (8,11). This technique can detect aneurysms that are missed by echocardiography (22) and can also detect more distal aneurysms that are identified with ultrasonography (13) along with SAA in any location in young children.…”

Section: Discussionmentioning

confidence: 99%

Vascular imaging findings with high-pitch low-dose dual-source CT in atypical Kawasaki disease

Kantarcı¹,

Güven²,

Ceviz³

et al. 2019

Diagn Interv Radiol

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Kawasaki disease (KD) is an acute, febrile, self-limited vasculitis that affects small-and medium-sized arteries, with a predilection for the coronary arteries (1). The disease mainly affects infants and children younger than 5 years of age. The etiology of KD is unknown, and there are no specific diagnostic tests (2). The diagnosis of this disease is ideally made by clinical criteria according to the American Heart Association. Typical or classical Kawasaki (TKD) disease can be diagnosed if a fever lasts longer than 5 days and if a patient has 4 of the 5 clinical features. However, according to the Japanese guidelines, atypical or incomplete Kawasaki disease (AKD) is defined as the presence of 4 or fewer of the main findings of KD regardless of the presence or absence of coronary artery aneurysm (CAA).In some cases with unexplained prolonged fever, the clinical features may be insufficient for the diagnosis of TKD. In this instance, AKD may be considered. Determining the presence of aneurysms in small-and medium-sized arteries is quite important in the diagnosis of AKD (3). CAAs are seen in up to 25% of cases, and systemic artery aneurysms (SAA) are seen in 2% (4). Especially in atypical cases, cardiac and other vascular complications can be more frequently seen because the diagnosis can be delayed. Therefore, early diagnosis and treatment is very important to prevent complications (5).There are several imaging modalities for scanning vascular structures, including echocardiography, magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US). In the diagnosis of AKD, each of these imaging techniques has specific handicaps. High-pitch low-dose CT angiography can be very useful in screening for CAA and associated SAA in patients with AKD. PURPOSEDetermining the presence of aneurysms, thrombosis, and stenosis is very important for the diagnosis of atypical Kawasaki disease (AKD) and in the follow-up of AKD patients with aneurysms. We aimed to demonstrate high-pitch low-dose dual-source computed tomography (CT) angiography findings in pediatric patients with AKD. METHODSOver a 5-year period, high-pitch low-dose CT angiography was performed to determine vascular aneurysms or occlusions in 17 patients who had suspected AKD. The patients ranged from 2 months of age to 11.3 years, with a mean age of 3 years. The American Heart Association's criteria were used to diagnose AKD. RESULTSWe did not detect any vascular problems in 6 of the patients, and they were not included in our study. Arterial aneurysms were present in 11 patients (aged 2 months to 11.3 years; mean age, 4.2 years; 7 males). In one patient, there was also a thrombus at an arterial aneurysm. Coronary artery aneurysms were detected in 7 patients and systemic artery aneurysms were detected in 7 patients. Three patients had both systemic and coronary aneurysms. CONCLUSIONOur results suggest that high-pitch low-dose dual-source CT can detect all types of aneurysms, stenosis and occlusions of vessels in patients with AKD who were not pre...

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Kawasaki Disease: Diagnosis and Follow-Up by CT Coronary Angiography with the Use of 128-Slice Dual Source Dual Energy Scanner. A Case Report

Cited by 5 publications

References 5 publications

Coronary artery aneurysm in kawasaki disease

Coronary artery aneurysm in kawasaki disease

Giant coronary artery aneurysm in infantile Kawasaki disease: When to use cardiac computed tomography angiography

Vascular imaging findings with high-pitch low-dose dual-source CT in atypical Kawasaki disease

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