Perivascular Brightness of Coronary Arteries in Kawasaki Disease

• Published in: The Journal of pediatrics Vol. 159; no. 3; pp. 454 - 457.e1
• Main Authors: Yu, Jeong Jin, Jang, Wan-Sook, Ko, Hong Ki, Han, Myung-Ki, Kim, Young-Hwue, Ko, Jae-Kon, Park, In-Sook
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.09.2011; Elsevier
• Subjects: Biological and medical sciences; blood; Cardiology. Vascular system; Case-Control Studies; Child, Preschool; Coronary heart disease; coronary vessels; Coronary Vessels - diagnostic imaging; Echocardiography; Female; General aspects; Heart; Humans; image analysis; Image Processing, Computer-Assisted; Infant; Male; Medical sciences; Mucocutaneous Lymph Node Syndrome; Mucocutaneous Lymph Node Syndrome - diagnostic imaging; patients; Pediatrics; pericardial effusion; Pericardial Effusion - diagnostic imaging; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; ultrasonography; RCA; Ebp; 2D; Em; Epc; LMCA; PEB; LAD; Echogenicity of blood pool; Two-dimensional; Echogenicity of perivascular tissue; Left anterior descending coronary artery; Perivascular echo brightness; Early diastolic tissue velocities of the basal lateral segment of the left ventricle; Right coronary artery; Left main coronary artery; Kawasaki syndrome; Immunopathology; Pediatrics; Autoimmune disease; Cardiovascular disease; Coronary heart disease; Vascular disease; Vasculitis; Blood vessel; Vision; Systemic disease; Stimulus brightness; Circulatory system
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2011.02.029

Because perivascular echo brightness (PEB) of coronary arteries has been proposed as a criterion for diagnosis of incomplete Kawasaki disease, we assessed the clinical importance of PEB during the acute phase of disease. We enrolled 58 patients with Kawasaki disease who underwent two-dimensional strain analysis of images of pericoronary tissue taken during the acute and the convalescent phases. Echogenicity of pericoronary tissue and of the blood pool was determined by speckle tracking in the respective areas of imaging as the averages of integrated backscatter over a single cardiac cycle. PEB was defined as echogenicity of pericoronary tissue minus blood pool. PEB did not differ in the acute phase in patients and control subjects ( P = .10) and between phases of disease ( P = .25). In comparison between patient groups, the presence of pericardial effusion was higher in patients with higher PEB during the acute phase (n = 30) than in the remaining patients (33% versus 4%, P < .01). PEB did not differ between patients and control subjects and is only associated with the presence of pericardial effusion during the acute phase of Kawasaki disease. Our data do not confirm the reliability of PEB as a useful diagnostic sign of incomplete Kawasaki disease.