Skip to main content
Log in

Relationships between coronary artery dilatation and severity of carditis detected by two-dimensional echocardiography and [99mTc] HMPAO-labeled white blood cell heart scan in children with Kawasaki disease

  • Originals
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Forty-one children (15 girls, 26 boys; ages 3.0±2.1 years) with Kawasaki disease (KD) were included in our study. The diameters of a total of 82 coronary arteries (CA), comprising 41 left (LCA) and 41 right (RCA), were computed by two-dimensional echocardiography (2D-Echo). If the diameter of the CA was≥20 mm, it was considered as dilated. The severity of the carditis was evaluated by [99mTc] HMPAO-labeled white blood cell (WBC) heart scans (Tc-WBC) carried out in all cases. On the basis of the results the children were divided into three groups. Group A children had the most severe carditis where the heart uptake was greater than the bone uptake; 11 of 32 (34.3%) of the CA in 16 cases were dilated. Group B had carditis of medium severity where the heart uptake was equal to the bone uptake; 11 of 28 (39.3%) of the CA in 14 cases were dilated. Group C had mild carditis where the heart uptake was less than the bone uptake; 9 of 22 (40.9%) of the CA in 11 cases were dilated. There were no significant differences among the three groups (p=0.87 by a chi-squared test). We conclude that no definite relationship exists between the severity of carditis and the dilatation of the CA in children with KD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fujiwara H, Hamashima Y (1978) Pathology of the heart in Kawasaki disease. Pediatrics 61: 100–107

    PubMed  Google Scholar 

  2. Kato H, Koike S, Yamamoto M, Ito Y, Yano E (1975) Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr 86: 892–898

    PubMed  Google Scholar 

  3. Fujiwara H, Chen C, Fujiwara T, Nishioka K, Kawai C, Hamashima Y (1980) Clinicopathologic study of abnormal Q waves in Kawasaki disease (mucocutaneous lymph node syndrome): an infantile cardiac disease with myocarditis and myocardial infarction. Am J Cardiol. 45: 797–804

    Article  PubMed  Google Scholar 

  4. Chung JK, Brandt L, Fulton DR, Keridberg MB (1982) Cardiac and coronary arterial involvement in infants and children from New England with mucocutaneous lymph node syndrome (Kawasaki disease). Am J Cardiol 50: 136–139

    Article  PubMed  Google Scholar 

  5. Hiraishi S, Yashiro K, Oguchi K, Kusano S, Ishii K, Nakazawa K (1981) Clinical course of cardiovascular involvement in the mucocutaneous lymph node syndrome. Am J Cardiol 47: 323–330

    Article  PubMed  Google Scholar 

  6. Satomi G, Nakimura K, Sakae N, Atsuyoshi T (1984) Systemic visualization of coronary arteries by two-dimensional echocardiography in children and infants: evaluation in Kawasaki's disease and coronary arteriovenous fistulas. Am Heart J 107: 497–504

    Article  PubMed  Google Scholar 

  7. Maeda T, Yoshida H, Funabashi T, Nakaya S, Takabatake S, Ohno T, Taniguchi N (1983) Subcostal 2-dimensional echocardiographic imaging of peripheral left coronary artery aneurysms in Kawasaki disease. Am J Cardiol 52: 48–52

    Article  PubMed  Google Scholar 

  8. Yoshida H, Maeda T, Funabashi T, Nakaya S, Takabatake S, Taniguchi N (1982) Subcostal two-dimensional echocardiographic imaging of peripheral right coronary artery in Kawasaki disease. Circulation 65: 956–961

    PubMed  Google Scholar 

  9. Kao CH, Hsieh KS, Wang YL, et al (1991) Comparison of Tc99m HMPAO labeled white blood cells and Ga-67 citrate scans to detect myocarditis in the acute phase of Kawasaki disease. Nucl Med Commun 12: 951–958

    PubMed  Google Scholar 

  10. Kao CH, Hsieh KS, Wang YL, et al (1992) Tc-99m HMPAO labeled WBC scan for the detection of myocarditis in different phases of Kawasaki disease. Clin, Nucl Med 3: 185–190

    Google Scholar 

  11. Kao CH, Hsieh KS, Wang YL, et al. (1992) Tc-99m HMPAO WBC imaging to detect carditis and to evaluate the results of high-dose gammaglobulin treatment in Kawasaki disease. Clin Nucl Med 8: 623–626

    Google Scholar 

  12. Kawasaki T (1984) Agreement with the guidelines by the Mucocutanous Lymph Node Syndrome Research Committee (in Japanese). Nippon Shonika Gakkai Zasshi 88: 2693

    Google Scholar 

  13. Kao CH, Wang YL, Wang SJ, Yeh SH (1992) Elution analysis and normal biodistribution of technetium-99m HMPAO labeled white blood cells. J Nucl. Med Technol 20: 224–227

    Google Scholar 

  14. Kawasaki T, Kousaki F (1967) Febrile oculo-oro-cutaneousarco-desquamatous syndrome with or without acute non-suppurative cervical lymphadenitis in infancy and children: clinical observations of 50 cases. Arerugi 16: 172–222

    Google Scholar 

  15. Morens DM, Anderson LJ, Hurwitz ES (1980) National surveillance of Kawasaki disease. Pediatrics 65: 21–25

    PubMed  Google Scholar 

  16. Kegel SM, Dorsey TJ, Rowen M, Taylor WF (1977) Cardiac death in mucocutaneous lymph node syndrome. Am J Cardiol 40: 282–286

    Article  PubMed  Google Scholar 

  17. Newburger JW, Takahashi M, Burns JC, et al. (1986) The treatment of Kawasaki syndrome with intravenous gammaglobulin. N Engl J Med 315 341–347

    PubMed  Google Scholar 

  18. Rose V (1990) Kawasaki syndrome: cardiovascular manifestations. J Rheumatol 17 [Suppl 24]: 11–14

    PubMed  Google Scholar 

  19. Yoshitake K, Naganuma M, Koike, et al (1980) Electrocardiographic findings in MCLS (in Japanese). Iryo 34: 24–27

    Google Scholar 

  20. Yamamoto S, Umezawa T, Hashiguchi R, Saji T, Matsuo N (1985) Serum, creatine kinase in Kawasaki disease (in Japanese). Shonkia Rinsho 38: 2312–2316

    Google Scholar 

  21. Sfakianakis GN, Al-Sheikh W, Heal A, et al (1982) Comparison of scintigraphy with In-111 leukocytes and Ga-67 in the diagnosis of occult sepsis. J Nucl Med 23: 618–626

    PubMed  Google Scholar 

  22. Thakur ML, Coleman RE, Welch MS (1977) Indium-111 labeled leukocytes for the localization of abscesses: preparation analysis, tissue distribution and comparison with gallium-67 citrate in dogs. J Lab Clin Med 89: 217–228

    PubMed  Google Scholar 

  23. Fujiwara H, Kawai C, Kasahara A, Hamashima Y (1979) Impairments of the coronary circulation in children: coronary arterial lesions and clinical findings in patients with Kawasaki disease (in Japanese). Rinsho Kagaku 15: 44–51

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kao, C.H., Hsieh, K.S., Chen, Y.C. et al. Relationships between coronary artery dilatation and severity of carditis detected by two-dimensional echocardiography and [99mTc] HMPAO-labeled white blood cell heart scan in children with Kawasaki disease. Pediatr Radiol 24, 41–44 (1994). https://doi.org/10.1007/BF02017659

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02017659

Keywords

Navigation