Coronary manifestations of Kawasaki Disease in computed tomography coronary angiography

Goh, Yong Geng; Ong, Ching Ching; Tan, Grace; Liang, Chong Ri; Soomar, Sanah Merchant; Lim, Chi Wan; Quek, Swee Chye; Teo, Lynette Ls

doi:10.1016/j.jcct.2017.12.003

Cited by 15 publications

(11 citation statements)

References 21 publications

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“…In uncomplicated cases, this should be performed at diagnosis and then at intervals of one to two weeks and four to six weeks [5]. In patients who have known coronary aneurysms following acute KD, CT coronary angiography should be performed to monitor progression [6]. Recent studies have also shown that its results are comparable to catheter angiography.…”

Section: Discussionmentioning

confidence: 99%

“…However, the exact dimensions of lesions can be difficult to assess on angiography as they may have significant thrombus burden or high calcium content. Therefore, intravascular ultrasound should ideally be employed to fully appreciate the actual dimension of these lesions before any intervention to ensure the correct size stent is employed for a given lesion [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

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Kawasaki Disease: An Unusual Case of a Retrospective Diagnosis in a 39-Year-Old Gentleman With Coronary Ectasias

Khan

Cheema

Ahmad

et al. 2020

Cureus

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Kawasaki disease (KD) was first reported by Dr. Tomisaku Kawasaki in 1967 and is classified as an autoimmune vasculitis of small-and medium-sized arteries. It is usually a self-limited condition occurring in childhood, but it can have complications such as coronary artery aneurysms, myocardial ischemia, and arrhythmias with significant morbidity and mortality presenting later in life. We report a case of a KD presenting in adulthood with late cardiovascular sequelae managed with coronary artery bypass graft.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Kawasaki Disease: An Unusual Case of a Retrospective Diagnosis in a 39-Year-Old Gentleman With Coronary Ectasias

Khan

Cheema

Ahmad

et al. 2020

Cureus

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“…Coronary computed tomography angiography (CCTA) is the first-line diagnostic imaging method for children with coronary artery diseases (1)(2)(3), such as those of abnormal origin (4) and coronary aneurysm (5). Reducing radiation and contrast medium doses while providing acceptable image quality (6,7), eliminating motion artifacts (8,9), and maintaining fast and easy operation remains the research focuses.…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Sun¹,

Li²,

Li³

et al. 2021

Quant Imaging Med Surg

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Background: Iterative reconstruction algorithms are often used to reduce image noise in low-dose coronary computed tomography angiography (CCTA) but encounter limitations. The newly introduced deep learning image reconstruction (DLIR) algorithm may provide new opportunities. We assessed the image quality and diagnostic performance of DLIR in low radiation dose and contrast medium dose CCTA of pediatric patients with 70 kVp and a shortened injection protocol.Methods: This was a prospective study. A total of 27 consecutive arrhythmic pediatric patients were enrolled in the study group and underwent CCTA using a prospective ECG-triggered single-beat protocol: tube voltage 70 kVp, automatic tube current modulation for a noise index (NI) of 22, and contrast dose of 0.4-0.6 mL/kg. Images were reconstructed with DLIR. They were compared with 27 matched patients in the control group scanned with 80 kVp, a lower NI setting (NI =19), and a higher contrast dose (0.8-1.2 mL/kg).The images in the control group were reconstructed using the adaptive statistical iterative reconstruction (ASIR-V) algorithm. The image contrast, image quality, and diagnostic confidence were assessed by 2 experienced radiologists using a 5-point scale (1: nondiagnostic and 5: excellent). The CT value and standard deviation of the aorta and perivascular tissue were measured, and the contrast-to-noise ratio (CNR) for the aorta was calculated. The contrast medium and radiation doses were compared. Results: The study and control groups had similar image contrast scores (4.75±0.57 vs. 4.78±0.42), image quality scores (3.67±0.47 vs. 3.44±0.51), and diagnostic confidence (4.74±0.44 vs. 4.74±0.45) (all P>0.05). There was an adequate enhancement in the aorta (614.74±127.73 vs. 705.89±111.20 HU) and similar CNR (20.34±4.64 vs. 20.99±4.14) in both groups. The image noise of the study group was lower in the aorta (30.61±3.88 vs. 34.77±3.49) and similar in perivascular tissue (27.66±6.24 vs. 27.55±3.33) compared with the control group. The study group reduced the total contrast medium dose by 53% to 15.07±3.68 ml and radiation dose by 36% to 0.57±0.31 mSv. Conclusions:The DLIR algorithm in CCTA for children using 70 kVp tube voltage with a shortened contrast medium injection protocol maintains image quality and diagnostic confidence while significantly reducing contrast medium dose and radiation dose compared with the use of the conventional CCTA protocol.

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“…Major pathological change in KD refers to systemic non-specific vasculitis, involving small and middle-sized blood vessels, especially coronary artery [3,4]. And coronary artery lesion represents its most serious complication, including myocardial infarction, coronary artery ectasia, coronary artery fistula and coronary artery aneurysm [5,6]. KD has become a primary reason for acquired heart diseases in pediatric department, and a risk factor for adult ischemic heart diseases [7].…”

Section: Introductionmentioning

confidence: 99%

CD32a polymorphism rs1801274 affects the risk of Kawasaki disease

Wang

Geng

2020

Artificial Cells, Nanomedicine, and Biotechnology

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Aim: To analyze the impact of CD32a polymorphism rs1801274 on the occurrence of Kawasaki disease (KD) through the meta-analysis. Methods: The correlation between CD32a polymorphism rs1801274 and the susceptibility to KD was appraised using summarized odds ratios (ORs) with their 95% confidence intervals (95% CIs). Besides, stratification analyses were further implemented on the basis of ethnicity and control source, respectively. Between-study heterogeneity was checked adopting chi-square-based Q test, with p < .05 as significant level. And results from Q test determined which model would be employed for OR calculation, fixed-or random-effects. Sensitivity analysis was accomplished to test the stability of final results. Potential publication bias among included studies was investigated using Begg's funnel plot and Egger's test. If publication bias was significant, its influence on overall estimates would be measured adopting the trim-and-fill method. Results: CD32a polymorphism rs1801274 significantly increased KD risk in total analysis under the comparisons of AA vs. GG, AA þ AG vs. GG, AA vs. GG þ AG, A vs. G and AG vs. GG (OR ¼ 2.69, 95% CI ¼ 1.39-5.20; OR ¼ 2.00, 95% CI ¼ 1.23-3.26; OR ¼ 1.90, 95% CI ¼ 1.23-2.94; OR ¼ 1.77, 95% CI ¼ 1.34-2.34; OR ¼ 1.53, 95% CI ¼ 1.07-2.19). After stratification analysis by ethnicity, similar tendency was also observed in Caucasian and Asian subgroups under corresponding genetic models. And parallel results were replicated in population-based and other-source subgroups after stratified analysis by control source, under some contrasts. Conclusion: CD32a polymorphism rs1801274 has strong relation to KD onset, and the presence of its A allele could elevate the disease incidence.

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Coronary manifestations of Kawasaki Disease in computed tomography coronary angiography

Cited by 15 publications

References 21 publications

Kawasaki Disease: An Unusual Case of a Retrospective Diagnosis in a 39-Year-Old Gentleman With Coronary Ectasias

Kawasaki Disease: An Unusual Case of a Retrospective Diagnosis in a 39-Year-Old Gentleman With Coronary Ectasias

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

CD32a polymorphism rs1801274 affects the risk of Kawasaki disease

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