Evaluation of Coronary Artery Aneurysms in Kawasaki Disease by Multislice Computed Tomographic Coronary Angiography
A 20-year-old woman visited our cardiology clinics for regular follow-up of Kawasaki disease. She was diagnosed with a giant coronary aneurysm at age 4. Her last coronary angiography was obtained 6 years before her current admission. To investigate the status of her coronary aneurysm, contrast-enhanced coronary computed tomographic (CT) angiography was performed with a 16-slice CT scanner. The CT was performed with retrospective ECG-gated technique using 80 mL of iodinated contrast medium injected intravenously. The scan was performed during a 20-second breath hold, with 0.75 mm collimation, 1.0 mm slice thickness, and 0.5 mm increment. Multiplanar reconstruction images showed a giant coronary aneurysm (16 mm) over the proximal segment of left anterior-descending artery and a small aneurysm distally (Figure, A). The findings were similar to those shown by catheterized coronary angiography taken 6 years earlier (Figure, B). However, the catheterized angiography could not precisely evaluate the extraluminal components, such as thrombi and aneurysmal shape. CT also visualized 2 distal small aneurysms better than the catheterized angiography of the right coronary artery (Figure, C, asterisks). As thallium-201 perfusion scintigraphy showed no evidence of myocardial ischemia and the patient was asymptomatic for daily activity, conservative therapy was continued.
This work was supported in part by the National Science Council under grant NSC-92-2314-B-75B-007.