Mucocutaneous lymph node syndrome. A cross-sectional echocardiographic diagnosis of coronary aneurysms

The cross-sectional echocardiographic technique for detecting coronary artery aneurysms of mucocutaneous lymph node syndrome (MLNS) was examined. When cutting the aortic root in round slices by the echocardiographic scanner, each of the right and left coronary arteries was imaged as a linear echo-free structure arising from the aortic root. Of 22 normal subjects, the left main coronary artery was imaged in all, the anterior descending branch in 18, the circumflex branch in six, and the right coronary artery in 18. Of 41 patients with MLNS, coronary artery aneurysms were detected as large echo-free spaces in four patients who were proved later to have these lesions by coronary angiography or autopsy. In addition, in four patients, whose echocardiograms demonstrated the coronary arteries to be normal, the angiographic studies showed that the coronary arteries were intact. These results suggest that the cross-sectional echocardiographic technique is a useful noninvasive diagnostic method for imaging the coronary arteries and the aneurysms in MLNS.