2017 Volume 77 Issue 1 Pages 48-58
Coronary lesions accompanying Kawasaki disease （KD） must be followed-up for long periods of time from childhood, necessitating the establishment of a non-invasive and accurate diagnosis method. Imaging by conventional coronary CT angiography （CCTA） was limited for children owing to high radiation exposure, high heart rate and also the difficulties to hold breath. Thanks to the progress in CT technology, the imaging of tachycardia cases has now become possible. Even if lower exposures are possible, this may be useful as an examination method, since such methods typically reveal KD coronary artery lesions. At our facility, 40 cases of patients with KD who underwent CCTA with 128-slice dual-source CT （DSCT） were evaluated regarding the usability and exposure thereof. The mean pulse rate at the time of photography was 72±15/min; however, the extraction rate of the proximal to intermediate segment which is the common site of coronary lesions for KD was high at 96％. The lesion detection rate and calcification detection was excellent. Regarding the evaluation of the lesion site, while the detection of expanded lesions was reliable, careful consideration had to be made regarding stenotic lesions because it was difficult to determine the stenotic rate in some cases. The mean effective dose was very low at 1.29±1.00 mSv, with the mean effective dose being super low at 0.93±0.65 mSv in one heart rate ultrafast helical photography group. With DSCT, it was possible to take low exposure photographs, at one-tenth of the conventional exposure dose, which was also sufficiently applicable in pediatric patients with fast heart rates. This may be useful as an examination method for KD coronary artery lesions.
