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(Circulation. 2000;101:e156.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Coronary Aneurysms in Kawasaki’s Disease Detected by Magnetic Resonance Coronary Angiography

Sebastian Flacke, MD; Randy M. Setser, MS; Philip Barger, MD; Samuel A. Wickline, MD; Christine H. Lorenz, PhD

From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo.

Correspondence to Christine H. Lorenz, PhD, Associate Professor of Medicine, Director, Center for Cardiovascular MR, Cardiovascular Division, Box 8086, Barnes-Jewish Hospital at Washington University Medical Center, 216 S Kingshighway Blvd, St Louis, MO 63110. E-mail chl@ccmr.wustl.edu

	Introduction

 
A20-year-old woman with a history of Kawasaki’s disease as a child and coronary aneurysms underwent cardiac MRI for reevaluation before an intended pregnancy. The patient regularly participated in athletic activities, and the physical examination was unremarkable. The ECG showed normal sinus rhythm and nonspecific T-wave abnormalities in the precordial leads. MRI (1.5-T ACS-NT, Philips Medical Systems) revealed normal left ventricular size and function. During an exercise stress test performed at the scanner with an MRI-compatible ergometer, the patient achieved 90% maximal predicted heart rate with no segmental wall abnormalities at peak exercise. ECG-triggered and navigator-gated and -corrected 3D coronary MR angiography was performed, demonstrating aneurysms of both the left and right coronary arteries (Figure 1). A turbo-field echo pulse sequence incorporating a T2 preparation pulse to enhance blood-myocardium contrast was used.¹ Images were acquired over multiple heartbeats with a 63-ms acquisition window in middiastole. Separate oblique data sets were acquired for the left and right coronary arteries. Both the right coronary artery and the left anterior descending coronary artery (LAD) could be clearly delineated up to 5.5 cm from their origin. Multiplanar reformats show a large aneurysm, 14x16x11 mm in diameter, of the proximal LAD at the junction of the left main, LAD, and left circumflex coronary arteries and a smaller aneurysm, 6 mm in diameter, in the proximal right coronary artery (Figures 2 and 3).

View larger version (190K): [in this window] [in a new window]   Figure 1. Single image of 3D data set acquired to delineate right coronary artery. Small aneurysm in proximal right coronary . . . [Full Text of this Article]