Discordance between thallium-201 scintigraphy and coronary angiography in patients with kawasaki disease: Myocardial ischemia with normal coronary angiogram
Discordance between thallium-201 scintigraphy and coronary angiography in patients with kawasaki disease: Myocardial ischemia with normal coronary angiogram
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川崎病患者铊201闪烁扫描与冠状动脉造影的不一致：心肌缺血但冠状动脉造影正常
DOI：
10.1007/bf00796982
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发表时间：
1993
影响因子：
1.6
通讯作者：
Y. Ichiya
中科院分区：
文献类型：
--
作者：
M. Fukazawa;J. Fukushige;T. Takeuchi;H. Narabayashi;H. Igarashi;T. Hijii;K. Ueda;Y. Kuwabara;M. Otsuka;Y. Ichiya
为了评估放射性核素试验在川崎病儿童冠状动脉闭塞病变检测中的价值，我们比较了34例患者（男19例，女15例）的应激性铊-201心肌单光子发射计算机断层扫描加双嘧达莫输注和冠状动脉造影的结果。仅在应力图像上的灌注缺陷被归类为短暂的，并且在延迟图像上存在重新分布的情况下归因于冠状动脉疾病。由于心肌损伤，其他人被归类为持续性。7名严重狭窄的儿童中有5名（71%）冠状动脉造影显示持续和/或短暂的灌注缺陷。然而，11例有动脉瘤但无明显狭窄的儿童中有6例（55%），16例血管造影正常的儿童中有4例（25%）表现出持续和/或短暂性缺陷。分析15例患儿20个单独的灌注缺损节段，6节段（30%）与供应冠状动脉狭窄有关，6节段（30%）与冠状动脉瘤有关，8节段（40%）与血管造影异常无关。因此，放射性核素和血管造影研究之间的显着不一致被证明。这些结果表明，传统上由血管造影和超声心动图补充定义的冠状动脉病变，可能不能完全识别所有未来可能发生心肌缺血或过去有心肌缺血的川崎患者。
To assess the usefulness of radionuclide tests in detecting coronary occlusive lesions in children with Kawasaki disease, we compared the results of stress thallium-201 myocardial single photon emission computed tomography with dipyridamole infusion and coronary angiography in 34 patients (19 males and 15 females). Perfusion defects on the stress image only were categorized as transient and were attributed to coronary vascular disease in the presence of redistribution on the delayed image. Others were classified as persistent, due to myocardial damage. Five of the seven children (71%) with severe stenosis on coronary angiography showed persistent and/or transient perfusion defects. However, six of the 11 children (55%) with aneurysms but no obvious stenosis, and four of the 16 children (25%) with normal angiography, showed persistent and/or transient defects. After analyzing 20 individual segments of perfusion defects in the 15 children, six segments (30%) were attributed to the stenosis of supplying coronary arteries, six segments (30%) were related to the coronary aneurysms, and eight segments (40%) were unrelated to any abnormalities on angiography. Thus, significant discordance between the radionuclide and angiographic studies was demonstrated. These results suggest that coronary lesions, as conventionally defined by angiography and supplemented by echocardiography, may not completely identify all Kawasaki patients who may develop myocardial ischemia in the future or who had ischemia in the past.