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Non-contrast magnetic resonance angiography for systemic artery evaluation in Kawasaki disease
Haruki Nonaka1, Masahiro Tahara2, Kazuya Sanada3
1Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima, Japan.
Insights
Non-contrast MRA effectively evaluates coronary and systemic arteries in Kawasaki disease patients. This method aids in detecting systemic artery aneurysms without increasing exam time or sedation.
Area of Science:
- Cardiovascular Imaging
- Pediatric Rheumatology
- Diagnostic Radiology
Background:
- Kawasaki disease (KD) is a systemic vasculitis affecting arteries.
- Evaluation of systemic arteries beyond coronaries is crucial in KD patients.
- Non-contrast magnetic resonance angiography (NC-MRA) is explored for comprehensive arterial assessment.
Purpose of the Study:
- To assess the feasibility of evaluating coronary aneurysms, systemic artery aneurysms (SAAs), and cerebrovascular diseases in KD patients using NC-MRA.
- To compare NC-MRA protocols for coronary and systemic artery evaluation.
Main Methods:
- NC-MRA protocols for coronary arteries (including vessel wall imaging) and systemic arteries (including head MRA) were applied.
- Image quality of SAAs was rated on a 4-point scale.
- Examination time and sedation dosage were compared between protocols.
Main Results:
- High image quality scores were achieved for SAAs in the aorta, subclavian, and renal arteries.
- No significant differences in examination time or sedation dose were observed between protocols.
- The systemic artery protocol identified SAAs in 7.1% of patients; no cerebrovascular disease was detected.
Conclusions:
- NC-MRA enables simultaneous evaluation of coronary and systemic arteries in KD patients.
- This approach is feasible without compromising examination duration or sedation levels.
- The systemic artery protocol is effective for detecting SAAs in KD.
Background:
Kawasaki disease (KD) is a systemic vasculitis; systemic arteries other than the coronary arteries should therefore also be evaluated. This study investigated the feasibility of evaluating coronary aneurysms, systemic artery aneurysms (SAAs), and cerebrovascular diseases in patients with KD using non-contrast magnetic resonance angiography (NC-MRA).
Methods:
Coronary artery protocols, including coronary magnetic resonance angiography (MRA) and vessel wall imaging, were performed in 57 examinations of 28 patients. Systemic artery protocol, including SAA scans and head MRA, along with coronary artery protocol, were performed in 42 examinations of 42 patients. The image quality of the SAAs was evaluated on a 4-point scale. Examination time and sedation dosage were compared between the protocols. The presence of SAAs and cerebrovascular disease was also evaluated.
Results:
The image quality score of SAAs was 4 (interquartile range [IQR]: 4-4) for the aorta, 4 (IQR: 3-4) for the subclavian artery, 4 (IQR: 3-4) for the renal artery, and 3 (IQR: 3-4) for the iliac artery. No differences were found between examination time (47.0 [IQR: 43.0-61.0] min vs. 51.0 [IQR: 45.0-60.0] min, p = 0.48) and sedative dose (4.63 [IQR: 3.93-5.79] mg/kg vs. 4.21 [IQR: 3.56-5.71] mg/kg, p = 0.37) between the protocols. Systemic artery protocol detected SAAs in three patients (7.1%), and cerebrovascular disease was not detected.
Conclusions:
Evaluating the coronary and systemic arteries in patients with KD using NC-MRA on a single examination was possible without compromising examination time or sedation dose. The systemic artery protocol was useful in finding SAAs.
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