Application of 3.0 T non-contrast coronary MR angiography in children with Kawasaki disease
10.3760/cma.j.cn112149-2021122-01034
- VernacularTitle:3.0 T无对比剂冠状动脉MR血管成像在川崎病儿童的应用价值
- Author:
Lingyi WEN
1
;
Zhongqin ZHOU
;
Chuan FU
;
Yingkun GUO
Author Information
1. 四川大学华西第二医院放射科 出生缺陷与相关妇儿疾病教育部重点实验室，成都610041
- Keywords:
Magnetic resonance imaging;
Coronary artery;
Kawasaki disease;
Transthoracic echocardiogram
- From:
Chinese Journal of Radiology
2022;56(10):1058-1063
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic accuracy and application value of 3.0 T non-contrast coronary magnetic resonance angiography (CMRA) in evaluating coronary artery in children with Kawasaki disease (KD).Methods:From May 2019 to January 2022, 75 children diagnosed with KD in our hospital were enrolled. All the patients underwent CMRA and transthoracic echocardiography (TTE) in one week, twenty-six of whom underwent coronary CT angiography (CCTA) or invasive coronary angiography (ICA) within two weeks. The diagnostic performance of CMRA and TTE was evaluated with CCTA/ICA as reference standard by per-patient basis, per-vessel basis, per-segment basis. Sensitivity and specificity of CMRA and TTE was compared by paired chi square test.The distribution of coronary artery aneurysm (CAA), thrombosis and other pathological changes of coronary artery were recorded and compared between two methods. The patients′ height and weight were collected to calculate the Z value. Z value>2.5 was defined as CAA.Results:All patients successfully completed CMRA examinations. Among the 26 patients, the sensitivity of CMRA was significantly higher than that of TTE by per coronary artery[97.7%(43/44)vs.84.1%(37/44), χ2=4.17, P<0.05]. CMRA showed a higher sensitivity than that of TTE both by proximal segments and middle/distal segments [97.7%(43/44)vs. 84.1%(37/44), 100%(21/21) vs. 52.4%(11/21), χ2=10.08, 7.11, both P<0.05). A total of 115 CAAs was found by CMRA, while only 87 (75.7%) CAAs were observed by TTE. Of the 28 (24.3%) CAAs missed by TTE, 16 (57.1%) were located in right coronary artery (RCA), 2(7.1%) in left main coronary artery, 7(25.0%) in left anterior ascending coronary artery (LAD) and 3(10.7%) in left circumflex coronary artery (LCX). Eleven (39.3%) missed CAAs by TTE were located in the proximal segment of RCA, LMCA, LAD and LCX, and 17 (60.7%) missed CAAs were located in the middle and distal segments. TTE missed coronary thrombosis in 5 patients compared with CMRA. Conclusions:3.0 T non-contrast CMRA is non-invasive and non-radiation, and the image quality can meet the needs of diagnosis, especially for detection of CAAs in RCA or in middle and distal segments of coronary artery in KD patients.
