Abstract 2764: The Advantages of using Multi-slice Spiral Computed Tomography to Evaluate Serious Coronary Complications in Adolescents after Kawasaki Disease

Objectives We identified novel multi-slice spiral computed tomography (MSCT) findings in adolescents after Kawasaki disease that could not be detected by coronary angiography (CAG). Methods We studied 18 patients who had suffered from serious coronary arterial lesions after Kawasaki disease (mean age: 21.7 years; range: 13 to 34 years). Seventeen patients had stenotic lesions, and all had coronary aneurysms. MSCT was performed using a Siemens SOMATOM Volume Zoom (4-detector row) or a Toshiba Aquillion 16 (16-detector row). The detection of coronary calcification, stenotic lesion, and intimal hypertrophy was applied to all coronary arteries in MSCT and compared to CAG. Results Of the 18 patients, there were 11 (61%) in whom novel findings were detected by MSCT. Coronary calcifications were found in 11 of the 18 patients (61%) by MSCT. Five patients had concentric calcified aneurysms, 4 had eccentric calcified aneurysms, and the other 2 had mixed calcified aneurysms. Coronary stenotic lesions were present in 6 of the 18 patients (33%) with calcified aneurysms. There were 2 patients who had intimal hypertrophy (11%). One patient had intimal hypertrophy along the left main trunk with a giant calcified aneurysm along the left anterior descending artery. Two patients had severe stenoses just distal to giant calcified aneurysms that were regarded as false positive findings, which were identified as mild stenoses by CAG. Conclusions MSCT offers advantages over CAG in the evaluation of calcified aneurysms and intimal hypertrophy, and has the potential to become a diagnostic modality for coronary intervention in adolescents after Kawasaki disease.