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Giant coronary aneurysm in a toddler with Kawasaki disease: technical challenges in CT coronary angiography
Yan Hei Chan1, Catherine Yee Man Young1, Ki Wang1
1Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Insights
Computed tomography coronary angiography (CTCA) can be challenging in children with giant coronary artery aneurysms (CAAs) due to altered blood flow. Optimizing CTCA protocols, including bolus tracking techniques, is crucial for accurate diagnosis in Kawasaki disease.
Area of Science:
- Cardiovascular Imaging
- Pediatric Rheumatology
Background:
- Kawasaki disease is a leading cause of acquired coronary artery aneurysms (CAAs) in children.
- Giant CAAs present unique challenges for diagnostic imaging.
Abstract:
Kawasaki disease is the most common vasculitis causing acquired coronary artery aneurysm (CAA) and affects mostly children. Computed tomography coronary angiography (CTCA) has unique diagnostic and prognostic values in cases of giant CAA. Here, we report technical challenges encountered when performed CTCA for a case of Kawasaki disease complicated with giant CAA. In particular, there was significant flow alteration caused by the giant CAA(s) causing suboptimal enhancement when the standard protocol was applied. We share our experience in optimizing the scan and propose the use of either manual bolus tracking or test bolus technique in similar scenarios, as well as multidisciplinary approach to optimize patient preparation.
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