Non‐contrast magnetic resonance angiography for systemic artery evaluation in Kawasaki disease

• Published in: Pediatrics international Vol. 65; no. 1; pp. e15704 - n/a
• Main Authors: Nonaka, Haruki, Tahara, Masahiro, Sanada, Kazuya, Okano, Mio, Morikawa, Yuko, Yoshiura, Takayuki, Nitta, Tetsuya, Urayama, Kotaro, Yoneyama, Masami, Imada, Naoyuki, Sato, Tomoyasu
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.01.2023
• Subjects: Anesthesia; Aneurysm; Aneurysms; Angiography; Aorta; Cerebrovascular disease; Cerebrovascular diseases; complication; Contrast Media; Coronary Aneurysm - diagnosis; Coronary artery; Coronary vessels; Feasibility studies; Humans; Iliac Artery; Kawasaki disease; Magnetic Resonance Angiography - methods; magnetic resonance imaging; Medical imaging; Mucocutaneous lymph node syndrome; Mucocutaneous Lymph Node Syndrome - diagnosis; Mucocutaneous Lymph Node Syndrome - diagnostic imaging; non‐contrast magnetic resonance angiography; Pediatrics; Renal artery; Renal Artery - pathology; systemic artery aneurysm; Systemic vasculitis; Vascular diseases; Veins & arteries; complication; magnetic resonance imaging; Kawasaki disease; systemic artery aneurysm; non-contrast magnetic resonance angiography
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.15704

Background Kawasaki disease (KD) is a systemic vasculitis; systemic arteries other than the coronary arteries should therefore also be evaluated. This study investigated the feasibility of evaluating coronary aneurysms, systemic artery aneurysms (SAAs), and cerebrovascular diseases in patients with KD using non‐contrast magnetic resonance angiography (NC‐MRA). Methods Coronary artery protocols, including coronary magnetic resonance angiography (MRA) and vessel wall imaging, were performed in 57 examinations of 28 patients. Systemic artery protocol, including SAA scans and head MRA, along with coronary artery protocol, were performed in 42 examinations of 42 patients. The image quality of the SAAs was evaluated on a 4‐point scale. Examination time and sedation dosage were compared between the protocols. The presence of SAAs and cerebrovascular disease was also evaluated. Results The image quality score of SAAs was 4 (interquartile range [IQR]: 4–4) for the aorta, 4 (IQR: 3–4) for the subclavian artery, 4 (IQR: 3–4) for the renal artery, and 3 (IQR: 3–4) for the iliac artery. No differences were found between examination time (47.0 [IQR: 43.0–61.0] min vs. 51.0 [IQR: 45.0–60.0] min, p = 0.48) and sedative dose (4.63 [IQR: 3.93–5.79] mg/kg vs. 4.21 [IQR: 3.56–5.71] mg/kg, p = 0.37) between the protocols. Systemic artery protocol detected SAAs in three patients (7.1%), and cerebrovascular disease was not detected. Conclusions Evaluating the coronary and systemic arteries in patients with KD using NC‐MRA on a single examination was possible without compromising examination time or sedation dose. The systemic artery protocol was useful in finding SAAs.