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Coronary Aneurysms in Kawasaki’s Disease Detected by Magnetic Resonance Coronary Angiography

2000; Lippincott Williams & Wilkins; Volume: 101; Issue: 14 Linguagem: Inglês

10.1161/01.cir.101.14.e156

1524-4539

Sebastian Flacke, Randy M. Setser, Philip M. Barger, Samuel A. Wickline, Christine H. Lorenz,

Cardiac Structural Anomalies and Repair

HomeCirculationVol. 101, No. 14Coronary Aneurysms in Kawasaki's Disease Detected by Magnetic Resonance Coronary Angiography Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessOtherPDF/EPUBCoronary Aneurysms in Kawasaki's Disease Detected by Magnetic Resonance Coronary Angiography Sebastian Flacke, Randy M. Setser, Philip Barger, Samuel A. Wickline and Christine H. Lorenz Sebastian FlackeSebastian Flacke From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo. , Randy M. SetserRandy M. Setser From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo. , Philip BargerPhilip Barger From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo. , Samuel A. WicklineSamuel A. Wickline From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo. and Christine H. LorenzChristine H. Lorenz From the Center for Cardiovascular MR, Cardiovascular Division, Barnes-Jewish Hospital at Washington University Medical Center, St Louis, Mo. Originally published11 Apr 2000https://doi.org/10.1161/01.CIR.101.14.e156Circulation. 2000;101:e156–e157A20-year-old woman with a history of Kawasaki's disease as a child and coronary aneurysms underwent cardiac MRI for reevaluation before an intended pregnancy. The patient regularly participated in athletic activities, and the physical examination was unremarkable. The ECG showed normal sinus rhythm and nonspecific T-wave abnormalities in the precordial leads. MRI (1.5-T ACS-NT, Philips Medical Systems) revealed normal left ventricular size and function. During an exercise stress test performed at the scanner with an MRI-compatible ergometer, the patient achieved 90% maximal predicted heart rate with no segmental wall abnormalities at peak exercise. ECG-triggered and navigator-gated and -corrected 3D coronary MR angiography was performed, demonstrating aneurysms of both the left and right coronary arteries (Figure 1). A turbo-field echo pulse sequence incorporating a T2 preparation pulse to enhance blood-myocardium contrast was used.1 Images were acquired over multiple heartbeats with a 63-ms acquisition window in middiastole. Separate oblique data sets were acquired for the left and right coronary arteries. Both the right coronary artery and the left anterior descending coronary artery (LAD) could be clearly delineated up to 5.5 cm from their origin. Multiplanar reformats show a large aneurysm, 14×16×11 mm in diameter, of the proximal LAD at the junction of the left main, LAD, and left circumflex coronary arteries and a smaller aneurysm, 6 mm in diameter, in the proximal right coronary artery (Figures 2 and 3).The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. Single image of 3D data set acquired to delineate right coronary artery. Small aneurysm in proximal right coronary artery is seen (small arrow), as well as a large circular aneurysm of LAD filling left atrioventricular groove (large arrow). Ao indicates aorta; PA, pulmonary artery; LA, left atrium; and RA, right atrium.Download figureDownload PowerPoint Figure 2. Multiplanar reformatted image of right coronary artery with a small aneurysm near its origin (arrow). Aneurysm is 6 mm in diameter. No associated stenosis is seen in remaining course of right coronary artery. Abbreviations as in Figure 1.Download figureDownload PowerPoint Figure 3. Large aneurysm is seen in LAD on reformatted image (arrow). Flow-related signal within aneurysm is homogeneous, with no evidence of thrombosis. LAD and left circumflex artery arise directly from aneurysm. Abbreviations as in Figure 1.FootnotesCorrespondence to Christine H. Lorenz, PhD, Associate Professor of Medicine, Director, Center for Cardiovascular MR, Cardiovascular Division, Box 8086, Barnes-Jewish Hospital at Washington University Medical Center, 216 S Kingshighway Blvd, St Louis, MO 63110. E-mail [email protected] References 1 Brittain JH, Hu BS, Wright GA, Meyer CH, Macovski A, Nishimura DG. Coronary angiography with magnetization-prepared T2 contrast. Magn Reson Med.1995; 33:689–696.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails April 11, 2000Vol 101, Issue 14Article InformationMetrics Download: 92 Copyright © 2000 by American Heart Associationhttps://doi.org/10.1161/01.CIR.101.14.e156 Originally publishedApril 11, 2000 PDF download