Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T22:18:58.988Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of coronary ischaemia by myocardial perfusion dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography, and coronary angiography in children with Kawasaki disease: pre- and post-coronary bypass grafting

Published online by Cambridge University Press:  05 August 2014

Mostafa S. Mostafa ,
Ashraf O. Sayed  and
Yasser M. Al Said
Mostafa S. Mostafa
Affiliation:
Department of Nuclear medicine, Assiut University, Egypt
Ashraf O. Sayed*
Affiliation:
Department of Pediatrics, Children and Women’s University Hospital, Minia University, P.O. Box 61519, El-Minia, Egypt
Yasser M. Al Said
Affiliation:
Department of Nuclear Medicine, Cairo University, Egypt
*
Correspondence to: Dr. A. O. Sayed, Department of Pediatrics, Children and Women’s University Hospital, Minia University, P.O. Box 61519, El-Minia, Egypt. Tel: +965 66486724; Fax: +2 086 2342813; E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Coronary artery lesions in Kawasaki disease invasively assessed by coronary angiography. Evaluation of myocardial perfusion by single-photon emission computed tomography may identify the haemodynamic significance of coronary lesions. Objective: To evaluate diagnostic accuracy of dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography as a possible alternative to invasive coronary angiography for detection and follow-up of myocardial ischaemia in patients with Kawasaki disease, and pre- and post-coronary bypass grafting. Patients and methods: Coronary angiography and single-photon emission computed tomography were performed on 21 patients who were classified into three groups – group I (stenosis), group II (giant aneurysms), and group III (small aneurysms). Of the 21 patients, 16 (groups I and II) patients with myocardial perfusion defects, who underwent coronary bypass grafting, were followed up with single-photon emission computed tomography. Result: In group I, all patients had significant coronary stenosis and 100% of them had perfusion defects in the anterior and septal walls. In group II, all patients had giant aneurysms and 83% of them had inferior and inferolateral perfusion defects. In group III, all patients had small aneurysms and 100% of them had normal perfusion. Pre-coronary bypass grafting myocardial ischaemic defects disappeared in all patients after surgery. Sensitivity, specificity, and accuracy of single-photon emission computed tomography were 94, 100, and 95%, respectively. Conclusion: Technetium-99 m tetrofosmin single-photon emission computed tomography can be applied as an accurate non-invasive diagnostic technique for detecting myocardial perfusion defects with coronary artery lesions, and to show improved or even normalised perfusion of the myocardium in patients after surgical revascularisation.

Keywords

Kawasaki diseasecoronary angiographysingle-photon emission computed tomography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 927 - 934
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kawasaki, T, Kosaki, F, Okawa, S, et al. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 1974; 54: 271–276.CrossRefGoogle ScholarPubMed
2. Newburger, JW, Takahashi, M, Burns, JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 1986; 315: 341–347.Google Scholar
3. Takahashi, M, Mason, W, Lewis, AB. Regression of coronary aneurysms in patients with Kawasaki syndrome. Circulation 1987; 75: 387–394.Google Scholar
4. Akagi, T, Rose, V, Benson, LN, et al. Outcome of coronary artery aneurysms after Kawasaki disease. J Pediatr 1992; 121: 689–694.Google Scholar
5. Kondo, C, Hiroe, M, Nakanishi, T, et al. Detection of coronary artery stenosis in children with Kawasaki disease. Usefulness of pharmacologic stress 201Tl myocardial tomography. Circulation 1989; 80: 615–624.Google Scholar
6. Kato, H, Sugimura, T, Akagi, T, et al. Long term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996; 94: 1379–1385.CrossRefGoogle ScholarPubMed
7. Burns, JC, Shimizu, C, Shike, H, et al. Family-based association analysis implicates IL-4 in susceptibility to Kawasaki disease. Genes Immun 2005; 6: 438–444.Google Scholar
8. Lee, TJ, Chun, JK, Yeon, SI, Shin, JS, Kim, DS. Increased serum levels of macrophage migration inhibitory factor in patients with Kawasaki disease. Scand J Rheumatol 2007; 36: 222–225.CrossRefGoogle ScholarPubMed
9. Wang, CL, Wu, YT, Liu, CA, Kuo, HC, Yang, KD. Kawasaki disease: infection, immunity and genetics. Pediatr Infect Dis J 2005; 24: 998–1004.Google Scholar
10. Kondo, C. Myocardial perfusion imaging in pediatric cardiology. Ann Nucl Med 2004; 18: 551–561.Google Scholar
11. Dajani, AS, Taubert, KA, Gerber, MA, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993; 87: 1776–1780.Google Scholar
12. Nakanishi, T, Takao, A, Nakazawa, M, et al. Mucocutaneous lymph node syndrome: clinical,hemodynamic and angiographic features of coronary obstructive disease. Am J Cardiol 1985; 55: 662–668.Google Scholar
13. Kondo, C, Hiroe, M, Nakanishi, T, et al. Detection of coronary artery stenosis in children with Kawasaki disease. Usefulness of pharmacologic stress 201Tl myocardial tomography. Circulation 1989; 80: 615–624.Google Scholar
14. Chiewvit, S, Durongpisitkul, K. Myocardial perfusion imaging in pediatric patients with Kawasaki disease. Siriraj Med J 2007; 59: 380–384.Google Scholar
15. Jan, SL, Hwang, B, Fu, YC, et al. Comparison of 201Tl SPET and treadmill exercise testing in patients with Kawasaki disease. Nucl Med Commun 2000; 21: 431–435.Google Scholar
16. Fukuda, T, Ishibashi, M, Yokoyama, T, et al. Myocardial ischemia in Kawasaki disease: evaluation with dipyridamole stress technetium 99 m tetrofosmin scintigraphy. J Nucl Cardiol 2002; 9: 632–637.Google Scholar
17. Karasawa, K, Ayusawa, M, Noto, N, et al. Optimum protocol of technetium-99 m tetrofosmin myocardial perfusion imaging for the detection of coronary stenosis lesions in Kawasaki disease. J Cardiol 1997; 30: 331–339.Google Scholar
18. Fu, YC, Shiau, YC, Tsai, SC, et al. Discordance between dipyridamole stress technetium-99 m tetrofosmin single photon emission computed tomography and coronary angiography in patients with Kawasaki disease. Int J Cardiovasc Imaging 2002; 18: 357–362.CrossRefGoogle Scholar
19. Ono, Y, Kohata, T, Iwatani, H, et al. Usefulness and limitations of stress 201-thallium myocardial imaging in patients with Kawasaki disease. J Cardiol 1991; 21: 437–444.Google ScholarPubMed
20. Onouchi, Z, Hamaoka, K, Kamiya, Y, et al. Transformation of coronary artery aneurysm to obstructive lesion and the role of collateral vessels in myocardial perfusion in patients with Kawasaki disease. J Am Coll Cardiol 1993; 21: 158–162.CrossRefGoogle ScholarPubMed
21. Miyagawa, M, Mochizuki, T, Murase, K, et al. Prognostic value of dipyridamole-thallium myocardial scintigraphy in patients with Kawasaki disease. Circulation 1998; 98: 990–996.Google Scholar
22. Naoe, S, Takahashi, K, Masuda, H, et al. Coronary findings post Kawasaki disease in children who died of other causes. In: Shulman ST ed. Kawasaki Disease. Alan R Liss, New York, NY, 1987: 341–346.Google ScholarPubMed
23. Paridon, S, Fnlioto, F, Vincent, I, et al. Exercise capacity and incidence of myocardial perfusion defects after Kawasaki disease in children and adolescents. J Am Coll Cardiol 1995; 25: 1420–1424.Google Scholar
24. Fukazawa, M, Fukushige, J, Takeuchi, T, et al. Discordance between thallium-201 scintigraphy and coronary angiography in patients with Kawasaki disease: myocardial ischemia with normal coronary angiogram. Pediatr Cardiol 1993; 14: 67–74.Google Scholar
25. Fukuda, T, Ishibashi, M, Shinohara, T, et al. Follow-up assessment of the collateral circulation in patients with Kawasaki disease who underwent dipyridamole stress technetium-99 m tetrofosmin scintigraphy. Pediatr Cardiol 2005; 269: 558–564.Google Scholar
26. Kelley, JD, Forster, AM, Highley, B, et al. Technetium-99 m-tetrofosmin: a new radiopharmaceutical for myocardial perfusion imaging. J Nucl Med 1993; 34: 222–227.Google Scholar
27. Sridhara, BS, Braatt, S, Itti, R, et al. Early and late myocardial imaging with a new technetium-99 m diphosphine (PPN 1011) in coronary artery disease (Abstract). J Am Coll Cardiol 1992; 19: 202A.Google Scholar
28. Jain, D, FJTh, Wackers, McMahon, M, et al. Is there any redistribution with Tc-99m-tetrofosmin imaging? A quantitative study using serial planar imaging (Abstract). Circulation 1992; 86: I-46.Google Scholar
29. Lee, DC, Simonetti, OP, Harris, KR, et al. Magnetic resonance versus radionuclide pharmacological stress perfusion imaging for flow-limiting stenoses of varying severity. Circulation 2004; 110: 58–65.Google Scholar
30. Schwitter, J, Wacker, CM, van Rossum, AC. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J 2008; 29: 480–489.Google Scholar
31. Tacke, C, Kuipers, I, Groenink, M, et al. Cardiac magnetic resonance imaging for noninvasive assessment of cardiovascular disease during the follow-up of patients with Kawasaki disease. Circ Cardiovasc Imaging 2011; 4: 712–720.Google Scholar