Imaging for the diagnosis and management of coronary artery complications in Kawasaki disease: Progress and application

Abstract

Coronary aneurysms and dilated lesions associated with patients with Kawasaki disease show various changes over time, including calcification of the aneurysm wall, intimal thickening, development of mural thrombi, development of collateral vessels, and asymptomatic thrombotic occlusion followed by subsequent post-occlusive recanalization. Both morphological and functional evaluations are necessary for their diagnosis and management.

Coronary CT angiography (CCTA) has recently superseded selective coronary angiography for morphological evaluation, whereas myocardial scintigraphy is used in myocardial perfusion imaging (MPI) for functional assessment. In recent years, semiconductor SPECT has shortened imaging times and enabled imaging to be performed in the sitting position, thus making the examination less invasive and more tolerable for younger patients.

Various novel imaging modalities might be applied in the future for the evaluation of coronary artery lesions associated with Kawasaki disease.