Reduced regional cerebral blood flow in patients with Kawasaki disease detected with 99mTc-HMPAO brain SPECT

Toshiyuki Hikita1）, Suguru Wakita1）, Tatsuro Kaminaga2）, Shin Kawagoe1）
Kaori Ogita1）, Kaori Amakata1）, Natsue Nakamoto1,3）, Yasushi Fujii1）, Hiroshi Oba2）
Yukishige Yanagawa1）
Department of Pediatrics1）, Radiology2）, Teikyo University School of Medicine
Department of Occupational Therapy3）, Mejiro University Faculty of Health Sciences

Abstract
　　Kawasaki disease (KD) is an acute febrile disease. It is a mucocutaneous lymph node syndrome associated with systemic arteritis, which has been demonstrated histologically. Abnormalities of the cerebral arteries have also been noted as a complication of this disease in the central nervous system. There have been previous reports of brain single photon emission computed tomography (SPECT) demonstrating localized cerebral hypoperfusion without abnormal neurological findings or clinical symptoms. The aim of the present study was to observe cerebral blood flow in KD with and without neurological symptoms, using SPECT.
Fifty-four patients had acute KD on admission to our hospital between April 2004 and May 2007. Neurological symptoms were observed in three cases (one case reporting disturbed consciousness and two cases of convulsions). The mean ages of the patients with and without neurological symptoms were 7.7 and 28.4 months, respectively.
SPECT (99mTc-hexamethylprophylene amine oxime) was performed on 13 patients with KD from day 6 to day 30. Their parents gave informed consent for their participation in the study. SPECT showed reduced perfusion in the frontal lobe in three patients with neurological symptoms, and abnormal localized reduced perfusion in five patients without neurological symptoms.
SPECT is a useful tool for detection of brain perfusion abnormality in patients with KD.

Keywords： Kawasaki disease, Cerebral blood flow, Single-photon emission computed tomography (SPECT), 99mTc hexamethylprophylene amine oxime (99mTc-HMPAO), Magnetic resonance imaging (MRI)