Cardiovascular medicine
Transthoracic ultrasonic visualisation of coronary aneurysm,
stenosis, and occlusion in Kawasaki disease
S Hiraishi, H Misawa, N Takeda, Y Horiguchi, N Fujino, N Ogawa, H Hirota
Department of
Paediatrics, Kitasato University School of Medicine, 1-15-1 Kitasato,
Sagamihara, Kanagawa 228, Japan
Correspondence to: Dr Hiraishi
Accepted 9
November 1999
OBJECTIVE
To determine the sensitivity and specificity of
our transthoracic echocardiographic technique using high frequency (7.5 MHz) transducers for identification of the presence and type of
coronary artery disease in patients with Kawasaki disease.
DESIGNThe results of the prospective echocardiographic
study in each of seven segments of the four major coronary arteries
were compared with the selective coronary angiograms.
SETTINGKitasato University Hospital.
SUBJECTS60 patients with Kawasaki disease, ranging in
age from 8.0 months to 22 years (median, 6.0 years).
RESULTSAdequate echocardiographic images were obtained
in 397 (95%) of 420 coronary segments. Coronary angiography showed the
presence of coronary aneurysms in 87 segments and stenosis or occlusion in 28. The overall sensitivity and specificity of cross sectional echocardiography for correctly identifying coronary aneurysms were 95%
and 99%, respectively; for correctly identifying coronary stenosis or
occlusion the values were 85% and 98% for the right coronary artery,
and 80% and 97% for the left anterior descending coronary artery.
Agreement on the presence or absence of coronary aneurysms and
obstructive lesions on echocardiograms between the two observers was
1.0 and 0.98, respectively.
CONCLUSIONSEchocardiography may provide a non-invasive
means of identifying the presence and type of coronary artery disease
in patients with Kawasaki disease.
Keywords: Kawasaki disease; coronary artery aneurysm; coronary artery stenosis; echocardiography
© 2000 by Heart
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Hiraishi, S., Hirota, H., Horiguchi, Y., Takeda, N., Fujino, N., Ogawa, N., Nakahata, Y.
(2002). Transthoracic Doppler assessment of coronary flow velocity reserve in children with Kawasaki disease: Comparison with coronary angiography and thallium-201 imaging. J Am Coll Cardiol
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