Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease

Gerald F. Greil, Matthias Stuber, René M. Botnar, Kraig V. Kissinger, Tal Geva, Jane W. Newburger, Warren J. Manning, Andrew J. Powell

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

Background - In patients with Kawasaki disease, serial evaluation of the distribution and size of coronary artery aneurysms (CAA) is necessary for risk stratification and therapeutic management. Although transthoracic echocardiography is often sufficient for this purpose initially, visualization of the coronary arteries becomes progressively more difficult as children grow. We sought to prospectively compare coronary magnetic resonance angiography (MRA) and x-ray coronary angiography findings in patients with CAA caused by Kawasaki disease. Methods and Results - Six subjects (age 10 to 25 years) with known CAA from Kawasaki disease underwent coronary MRA using a free-breathing T2-prepared 3D bright blood segmented k-space gradient echo sequence with navigator gating and tracking. All patients underwent x-ray coronary angiography within a median of 75 days (range, 1 to 359 days) of coronary MRA. There was complete agreement between MRA and x-ray angiography in the detection of CAA (n=11), coronary artery stenoses (n=2), and coronary occlusions (n=2). Excellent agreement was found between the 2 techniques for detection of CAA maximal diameter (mean difference=0.4±0.6 mm) and length (mean difference=1.4±1.6 mm). The 2 methods showed very similar results for proximal coronary artery diameter (mean difference=0.2±0.5 mm) and CAA distance from the ostia (mean difference=0.1±1.5 mm). Conclusion - Free-breathing 3D coronary MRA accurately defines CAA in patients with Kawasaki disease. This technique may provide a non-invasive alternative when transthoracic echocardiography image quality is insufficient, thereby reducing the need for serial x-ray coronary angiography in this patient group.

Original languageEnglish (US)
Pages (from-to)908-911
Number of pages4
JournalCirculation
Volume105
Issue number8
DOIs
StatePublished - Feb 26 2002

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Mucocutaneous Lymph Node Syndrome
Magnetic Resonance Angiography
Coronary Aneurysm
Coronary Angiography
Young Adult
Coronary Vessels
X-Rays
Echocardiography
Respiration
Coronary Stenosis
Coronary Occlusion
Angiography

Keywords

  • Aneurysm
  • Angiography
  • Kawasaki disease
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Greil, G. F., Stuber, M., Botnar, R. M., Kissinger, K. V., Geva, T., Newburger, J. W., ... Powell, A. J. (2002). Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease. Circulation, 105(8), 908-911. https://doi.org/10.1161/hc0802.105563

Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease. / Greil, Gerald F.; Stuber, Matthias; Botnar, René M.; Kissinger, Kraig V.; Geva, Tal; Newburger, Jane W.; Manning, Warren J.; Powell, Andrew J.

In: Circulation, Vol. 105, No. 8, 26.02.2002, p. 908-911.

Research output: Contribution to journalArticle

Greil, GF, Stuber, M, Botnar, RM, Kissinger, KV, Geva, T, Newburger, JW, Manning, WJ & Powell, AJ 2002, 'Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease', Circulation, vol. 105, no. 8, pp. 908-911. https://doi.org/10.1161/hc0802.105563
Greil, Gerald F. ; Stuber, Matthias ; Botnar, René M. ; Kissinger, Kraig V. ; Geva, Tal ; Newburger, Jane W. ; Manning, Warren J. ; Powell, Andrew J. / Coronary magnetic resonance angiography in adolescents and young adults with Kawasaki disease. In: Circulation. 2002 ; Vol. 105, No. 8. pp. 908-911.
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AU - Stuber, Matthias

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AU - Newburger, Jane W.

AU - Manning, Warren J.

AU - Powell, Andrew J.

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N2 - Background - In patients with Kawasaki disease, serial evaluation of the distribution and size of coronary artery aneurysms (CAA) is necessary for risk stratification and therapeutic management. Although transthoracic echocardiography is often sufficient for this purpose initially, visualization of the coronary arteries becomes progressively more difficult as children grow. We sought to prospectively compare coronary magnetic resonance angiography (MRA) and x-ray coronary angiography findings in patients with CAA caused by Kawasaki disease. Methods and Results - Six subjects (age 10 to 25 years) with known CAA from Kawasaki disease underwent coronary MRA using a free-breathing T2-prepared 3D bright blood segmented k-space gradient echo sequence with navigator gating and tracking. All patients underwent x-ray coronary angiography within a median of 75 days (range, 1 to 359 days) of coronary MRA. There was complete agreement between MRA and x-ray angiography in the detection of CAA (n=11), coronary artery stenoses (n=2), and coronary occlusions (n=2). Excellent agreement was found between the 2 techniques for detection of CAA maximal diameter (mean difference=0.4±0.6 mm) and length (mean difference=1.4±1.6 mm). The 2 methods showed very similar results for proximal coronary artery diameter (mean difference=0.2±0.5 mm) and CAA distance from the ostia (mean difference=0.1±1.5 mm). Conclusion - Free-breathing 3D coronary MRA accurately defines CAA in patients with Kawasaki disease. This technique may provide a non-invasive alternative when transthoracic echocardiography image quality is insufficient, thereby reducing the need for serial x-ray coronary angiography in this patient group.

AB - Background - In patients with Kawasaki disease, serial evaluation of the distribution and size of coronary artery aneurysms (CAA) is necessary for risk stratification and therapeutic management. Although transthoracic echocardiography is often sufficient for this purpose initially, visualization of the coronary arteries becomes progressively more difficult as children grow. We sought to prospectively compare coronary magnetic resonance angiography (MRA) and x-ray coronary angiography findings in patients with CAA caused by Kawasaki disease. Methods and Results - Six subjects (age 10 to 25 years) with known CAA from Kawasaki disease underwent coronary MRA using a free-breathing T2-prepared 3D bright blood segmented k-space gradient echo sequence with navigator gating and tracking. All patients underwent x-ray coronary angiography within a median of 75 days (range, 1 to 359 days) of coronary MRA. There was complete agreement between MRA and x-ray angiography in the detection of CAA (n=11), coronary artery stenoses (n=2), and coronary occlusions (n=2). Excellent agreement was found between the 2 techniques for detection of CAA maximal diameter (mean difference=0.4±0.6 mm) and length (mean difference=1.4±1.6 mm). The 2 methods showed very similar results for proximal coronary artery diameter (mean difference=0.2±0.5 mm) and CAA distance from the ostia (mean difference=0.1±1.5 mm). Conclusion - Free-breathing 3D coronary MRA accurately defines CAA in patients with Kawasaki disease. This technique may provide a non-invasive alternative when transthoracic echocardiography image quality is insufficient, thereby reducing the need for serial x-ray coronary angiography in this patient group.

KW - Aneurysm

KW - Angiography

KW - Kawasaki disease

KW - Magnetic resonance imaging

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