Utility of coronary MR angiography and myocardial MR imaging for patients with Kawasaki disease

Atsuko Suzuki
Department of Pediatrics, Tokyo Teishin Hospital

Abstract
　　Coronary arterial aneurysms caused by Kawasaki disease may often develop into obstructive arterial lesions. This may lead to myocardial ischemia or sudden death, which can occur from the early to the late phase. Patients have therefore been followed up throughout their lives by frequent X-ray coronary angiography. Although X-ray coronary angiography is considered to be the gold standard for the detection of coronary lesions, it is an invasive, hazardous, and expensive procedure. As a noninvasive examination, magnetic resonance coronary angiography (MRCA) has developed remarkably over the past few years. Up to now, we have performed non-contrast enhanced, free-breathing MRCA for 635 patients with Kawasaki disease. Their ages ranged from 4 months to 37 years. MRCA proved to be a useful method for evaluating all types of coronary arterial lesions and intimal thickening, for all states of the disease. MR myocardial imaging was also performed for 57 patients with obstructive lesions, and proved to be useful for detecting even small myocardial infarctions and thin subendocardial infarctions which were not detectable detected by radio-isotopic imaging. MR imaging can thus reduce the amount of diagnostic catheterization and radio-isotopic myocardial imaging.

Keywords： MR coronary angiography, MR myocardial imaging, Coronary aneurysms, Intimal thickening, Recanalized vessels