In patients with Kawasaki disease, a comprehensive
cardiac MRI protocol identified coronary artery pathology, ischemia and MI and
compared favorably with echocardiography, new data suggested.
From September 2007 to October 2010, 63 patients (mean
age, 14.6 years; 74.6% male) aged at least 8 years with Kawasaki disease
underwent a comprehensive cardiac MRI protocol for routine coronary artery
surveillance. The protocol included adenosine stress testing to evaluate
complications. Before cardiac MRI performance, patients were assigned to three
groups based on echocardiography data: patients without coronary artery
aneurysms (n=41), patients with transient coronary artery aneurysms (n=12) and
patients with persistent coronary artery aneurysms (n=10).
Researchers found normal coronary arteries in 46
patients using cardiac MRI and 23 coronary artery aneurysms in 15 patients.
Thrombus formation was detected in six coronary artery aneurysms in four
patients, wall motion disturbances and ischemia in four patients and delayed
hyperenhancement indicating MI in five patients. Researchers also observed wall
motion and perfusion abnormalities in territories supplied by affected coronary
Cardiac MRI results and recent echocardiography findings
were also compared in all patients. On cardiac MRIs that showed no coronary
artery aneurysms, recent echocardiography showed normal coronary arteries.
However, “in six of the 15 patients with coronary artery aneurysms on
cardiac MRI, coronary artery aneurysms were not detected by
echocardiography,” according to the researchers.
“We recommend future studies to incorporate cardiac
MRI in the guidelines for follow-up of patients with Kawasaki disease,”
the researchers concluded.
Disclosure: The researchers report no relevant