Computed tomography predict regression of coronary artery aneurysm in patients with Kawasaki disease
Po-Ting Chen1, Ming-Tai Lin2, Yih-Sharng Chen3
1Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Coronary artery aneurysms (CAAs) in Kawasaki disease (KD) patients are less likely to regress if calcified. Smaller, ectatic, non-calcified aneurysms in younger patients show better regression potential.
Area of Science:
- Cardiology
- Pediatric Rheumatology
- Medical Imaging
Background:
- Kawasaki disease (KD) can lead to coronary artery aneurysms (CAAs).
- Understanding CAA regression is crucial for managing KD patients.
- Cardiac CT is a key imaging modality for evaluating CAAs.
Purpose of the Study:
- To identify factors influencing the regression of CAAs in KD patients.
- To assess the role of imaging characteristics in predicting CAA regression.
- To analyze clinical and laboratory data associated with CAA regression.
Main Methods:
- Retrospective analysis of 37 CAAs in 18 KD patients from cardiac CT scans (2004-2015).
- Aneurysms categorized into regressed and non-regressed groups.
- Comparison of clinical symptoms, laboratory data, and imaging features between groups.
Main Results:
- 14 out of 37 CAAs (37%) showed regression.
- Regression was more common in aneurysms with smaller diameter, ectatic shape, no calcification, and in younger patients at disease onset.
- Maximal diameter of 5.6 mm was a significant predictor for CAA regression.
Conclusions:
- Calcified CAAs in KD patients have a lower likelihood of regression.
- Aneurysm size, shape, and patient's age at disease onset are key factors influencing CAA regression.
- Early identification of these factors can aid in clinical management.
Background/Purpose:
The study evaluated possible factors influencing the regression of coronary artery aneurysm (CAA) in patients with Kawasaki disease (KD) through electrocardiographically gated cardiac computed tomography (CT).
Methods:
18 patients with KD exhibited CAAs in at least 2 CT examinations conducted from December 2004 to September 2015, and 37 aneurysms were observed. Every aneurysm was corrected through the descending aorta at the origin level of the left main coronary artery under a normal distribution and measured under a fixed window level. These aneurysms were divided into 2 groups according to regression. Clinical symptoms, laboratory data, and imaging characteristics of both groups were analyzed.
Results:
All the aneurysms of 4 patients decreased in size, and totally, 14 aneurysms (37%) regressed. CAA regression tends to occur early after disease onset. No significant differences were observed in sex, aneurysm location, and the distance to the orifice between the 2 groups. The aneurysms with no calcification (p = 0.012), smaller diameter (p = 0.004), younger disease onset age (p = 0.048), and ectatic shape (p < 0.001) were more likely to regress according to univariate analysis. Receiver operating characteristic analysis revealed that the possible cut-off point of the maximal diameter to yield the highest sensitivity (91.3%) and specificity (92.9%) to predict CAA regression was 5.6 mm.
Conclusion:
Calcified CAAs in patients with KD was less likely to regress. The aneurysm size and shape as well as disease onset age were possible factors influencing regression.
More Related Videos
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests