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Quantitative Assessment of Myocardial Edema by MR T2 Mapping in Children With Kawasaki Disease
Lei Hu1, Shi-Gan-Mo A-Zhe1, Zhong-Qin Zhou1
1Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Myocardial edema in Kawasaki disease (KD) is highest in the acute phase, decreasing in the chronic phase, and persists regardless of coronary artery dilation. Disease stage and heart rate predict T2 values.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Medical Imaging
Background:
- Myocardial inflammation assessment in Kawasaki disease (KD) using Cardiovascular Magnetic Resonance Imaging (CMR) is limited.
- Understanding myocardial involvement in KD is crucial for patient management.
Purpose of the Study:
- To quantify myocardial edema in KD patients using T2 mapping.
- To identify independent predictors of T2 values in KD patients.
Main Methods:
- Prospective study involving 90 KD patients (acute and chronic phases) and 31 healthy controls.
- Utilized 3.0 T MRI with T2-weighted sequences for T2 mapping.
- Statistical analyses included t-tests, ANOVA, correlation, ROC, and multivariable regression.
Main Results:
- Global T2 values were highest in acute KD, followed by chronic KD and controls.
- Myocardial edema persisted in KD patients irrespective of coronary artery dilation.
- Disease stage and heart rate were independently associated with global T2 values.
Conclusions:
- Myocardial edema is more severe in acute-phase KD compared to chronic-phase.
- T2 mapping effectively quantifies myocardial edema in KD.
- T2 values are influenced by disease stage and heart rate, not coronary artery dilation.
Background:
Few studies assessed myocardial inflammation using Cardiovascular Magnetic Resonance Imaging in Kawasaki disease (KD) patients.
Purpose:
To quantify myocardial edema in KD patients using T2 mapping and explore the independent predictors of T2 values.
Study Type:
Prospective.
Subjects:
Ninety KD patients including 40 in acute phase (26 males, 65.0%) and 50 in chronic phase (34 males, 68.0%). Thirty-one healthy volunteers (21 males, 70.0%).
Field Strength/Sequence:
3.0 T T2-weighted Turbo Spin Echo-Short Time of Inversion Recovery sequence, True fast imaging with steady precession flash sequence and fast low-angle shot 3D spoiled gradient echo sequence.
Assessment:
T2 values were compared among KD groups and controls.
Statistical Test:
Student's t test and Fisher's exact test; One-way analysis of variance; Pearson correlation analysis; Receiver operating curve analysis; Multivariable linear regression.
Results:
Global T2 value of KD patients in acute phase was the highest, followed by those of chronic-phase patients and controls (38.83 ± 2.41 msec vs. 37.55 ± 2.28 msec vs. 36.05 ± 1.64 msec). Regional T2 values showed a same trend. There were no significant differences in global and regional T2 values between KD patients with and without coronary artery (CA) dilation, no matter in acute or chronic phase (all KD patients: P = 0.51, 0.51, 0.53, 0.72; acute KD: P = 0.61, 0.37, 0.33, 0.83; chronic KD: P = 0.65, 0.79, 0.62, 0.79). No significant difference was observed in global T2 values between KD patients with Z score > 5.0 and 2.0 < Z score ≤ 5.0 (P = 0.65). Multivariate analysis demonstrated that stage of disease (β = -0.123) and heart rate (β = 0.280) were independently associated with global T2 values.
Data Conclusion:
The degree of myocardial edema was more severe in acute-phase than in chronic-phase KD patients. Myocardial edema persists in patients regardless of the existence or degree of CA dilation.
Evidence Level:
2 TECHNICAL EFFICACY: Stage 2.
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