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Utility of Coronary MR Angiography in Children with Kawasaki Disease

¹ Department of Radiology, Tokyo Postal Services Agency Hospital, Chiyoda-ku, Fujimi 2-chome, 14-23, Tokyo, Japan 102-8798.
² Department of Pediatrics, Tokyo Postal Services Agency Hospital, Tokyo, Japan.
³ Department of Pediatrics, Japan Red-Cross Medical Center, Tokyo, Japan.

View larger version (11K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Graph shows rate of visualization of each segment of coronary artery (n = 35). LCX = left circumflex branch, LAD = left anterior descending branch, LMT = left main trunk, RCA = right coronary artery.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —1-year-5-month-old boy with Kawasaki disease. Ao = aorta. MR coronary angiograms obtained with cardiac coil made for adults while disease is in acute stage shows left anterior descending branch (arrow, A), left circumflex branch (arrowhead), and aneurysm at bifurcation of left coronary artery (triangle). Although aneurysm is evident, image is not clear.

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —1-year-5-month-old boy with Kawasaki disease. Ao = aorta. MR coronary angiograms obtained with cardiac coil made for adults while disease is in acute stage shows left anterior descending branch (arrow, A), left circumflex branch (arrowhead), and aneurysm at bifurcation of left coronary artery (triangle). Although aneurysm is evident, image is not clear.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —1-year-5-month-old boy with Kawasaki disease. Ao = aorta. MR coronary angiograms obtained with Flex-M coil (Philips Medical Systems) while disease is in convalescent stage shows left anterior descending branch (arrow, C), and left circumflex branch (arrowhead). Regression of aneurysm was verified. Image is clear and shrinkage of aneurysm is evident.

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —1-year-5-month-old boy with Kawasaki disease. Ao = aorta. MR coronary angiograms obtained with Flex-M coil (Philips Medical Systems) while disease is in convalescent stage shows left anterior descending branch (arrow, C), and left circumflex branch (arrowhead). Regression of aneurysm was verified. Image is clear and shrinkage of aneurysm is evident.

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Coronary angiogram of right coronary artery shows aneurysm (triangles).

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Coronary angiogram of left coronary artery shows aneurysms of left anterior descending branch (arrow) and left circumflex branch (arrowhead).

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Maximum-intensity-projection whole-heart coronary angiogram obtained 3 days after A and B shows aneurysm (triangles) on right coronary artery. Ao = aorta.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Maximum-intensity-projection whole-heart coronary angiogram obtained in same examination as C shows left anterior descending branch (arrow). Ao = aorta.

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3E —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Maximum-intensity-projection whole-heart coronary angiogram obtained in same examination as C and D shows left circumflex branch (arrowhead). Ao = aorta.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3F —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Soap-bubble maximum-intensity-projection image shows all three branches in one plane. Triangle indicates right coronary artery; arrow, left anterior descending branch; arrowhead, left circumflex branch. Ao = aorta.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3G —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Reconstructed volume-rendered images (G, whole heart; H, heart removed and remaining coronary arteries) show aneurysms at segment 1 in right coronary artery (triangles), left anterior descending artery (arrow), and left circumflex artery (arrowhead).

View larger version (60K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3H —3-year-11-month-old boy with Kawasaki disease and giant coronary aneurysms of segments 1–7 and 11. Reconstructed volume-rendered images (G, whole heart; H, heart removed and remaining coronary arteries) show aneurysms at segment 1 in right coronary artery (triangles), left anterior descending artery (arrow), and left circumflex artery (arrowhead).

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —5-year-7-month-old boy with Kawasaki disease. Dilated lesion (arrow) was visualized on left anterior descending branch (segment 6) on all reconstructed images. Coronal oblique (A) and axial oblique (B) maximum-intensity-projection images. Ao = aorta.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —5-year-7-month-old boy with Kawasaki disease. Dilated lesion (arrow) was visualized on left anterior descending branch (segment 6) on all reconstructed images. Coronal oblique (A) and axial oblique (B) maximum-intensity-projection images. Ao = aorta.

View larger version (143K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —5-year-7-month-old boy with Kawasaki disease. Dilated lesion (arrow) was visualized on left anterior descending branch (segment 6) on all reconstructed images. Soap-bubble maximum-intensity-projection image. Ao = aorta.

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —5-year-7-month-old boy with Kawasaki disease. Dilated lesion (arrow) was visualized on left anterior descending branch (segment 6) on all reconstructed images. Volume-rendered image.

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