Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease
Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease
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DOI：
10.1161/circimaging.111.965996
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发表时间：
2011-11-01
影响因子：
7.5
通讯作者：
Kuijpers, Taco W.
中科院分区：
文献类型：
--
作者：
Tacke, Carline E.;Kuipers, Irene M.;Kuijpers, Taco W.
川崎病（KD）是儿童获得性冠状动脉疾病最常见的原因。在KD中，美国心脏协会推荐超声心动图用于常规冠状动脉监测和核灌注扫描以及选择患者的常规冠状动脉造影。心脏MRI（CMRI）可能是一种无创和无辐射的替代方法。我们应用CMRI随访期间的KD患者和评估的性能CMRI与echocardiogram.Methods和Results-patients与KD年龄>= 8岁被连续纳入。63例患者（中位年龄14.6岁; 74.6%男性）接受了包括腺苷负荷试验在内的综合CMRI方案，以评价冠状动脉解剖结构、缺血和心肌梗死。所有患者均接受了CMRI，无明显并发症。在CMRI上，15例患者共发现23个冠状动脉瘤（CAAs）。CMRI检测到4例患者的6个CAAs中的血栓形成，4例患者的室壁运动障碍和缺血，5例患者的延迟性高增强指示心肌梗死。在受影响的冠状动脉供血区观察到室壁运动和灌注异常。将CMRI结果与最近的超声心动图结果进行比较。在6的15例CAAs对CMRI，CAAs没有检测到由echocardios. Conclusions一个全面的CMRI协议，包括腺苷负荷试验是可行的，以确定冠状动脉病变，缺血，心肌梗死在以前的KD患者，并与超声心动图相比，毫不逊色。CMRI可作为一种无创、无辐射的冠状动脉成像方法，用于KD患者的长期随访。(Circ血管造影。2011;4：712-720）。
Background-Kawasaki disease (KD) is the most common cause of acquired coronary artery disease in childhood. In KD, the American Heart Association recommends echocardiography for routine coronary artery surveillance and nuclear perfusion scans and conventional coronary angiography in select patients. Cardiac MRI (CMRI) may be a noninvasive and radiation-free alternative. We applied CMRI during the follow-up of patients with KD and assessed the performance of CMRI compared with echocardiography.Methods and Results-Patients with KD aged >= 8 years were consecutively included. Sixty-three patients (median age, 14.6 years; 74.6% male sex) underwent a comprehensive CMRI protocol including adenosine stress testing to evaluate coronary artery anatomy, ischemia, and myocardial infarction. All patients underwent CMRI without significant complications. On CMRI, 23 coronary artery aneurysms (CAAs) were identified in 15 patients. CMRI detected thrombus formation in 6 CAAs in 4 patients, wall motion disturbances and ischemia in 4 patients, and delayed hyperenhancement indicating myocardial infarction in 5 patients. Wall motion and perfusion abnormalities were noted in territories supplied by affected coronary arteries. CMRI results were compared with recent echocardiography findings. In 6 of the 15 patients with CAAs on CMRI, CAAs were not detected by echocardiography.Conclusions-A comprehensive CMRI protocol including adenosine stress testing is feasible to identify coronary artery pathology, ischemia, and myocardial infarction in former patients with KD and compares favorably with echocardiography. CMRI may be used as a noninvasive and radiation-free imaging method for coronary artery surveillance during the long-term follow-up of patients with KD. (Circ Cardiovasc Imaging. 2011;4:712-720.)