Detection of coronary artery damage at sub-acute phase of Kawasaki disease with myocardial perfusion imaging and two-dimensional echocardiography

Objective To compare the diagnostic values of rest 99Tcm-MIBI MPI and two-dimensional echocardiography (2-DE) for the detection of coronary artery damage at sub-acute phase of Kawasaki disease (KD).Methods Twenty-four children (14 males and 10 females,mean age:(2.50±2.19)years) with KD at sub-acute phase were studied between August 1999 and March 2012.All patients underwent rest 99Tcm-MIBI MPI and 2-DE.x2 and Wilcoxon rank sum tests with SPSS 13.0 were used for data analysis.Results The positive rate of MPI was 66.67％ (16/24),significantly higher than that of 2-DE (37.50％,9/24; x2 =4.00,P＜0.05).There was no significant difference between the duration for definite diagnosis by MPI and 2-DE ((13.79±2.86) vs (15.89±5.60) d; Z=-0.746,P＞0.05).Eight of 24 patients (33.33％) had positive results for both MPI and 2-DE,and 7 patients (29.17％) had negative findings for both methods.Eight patients (8/24,33.33％) were positive on MPI but negative on 2-DE,and 1 patient (1/24,4.17％) was positive on 2-DE but negative on MPI.The areas of myocardial ischemia detected by MPI in 4 patients were consistent with the findings by 2-DE.Conclusions Rest 99Tcm-MIBI MPI is a valuable noninvasive method to evaluate the coronary circulation and myocardial ischemia in KD patients at sub-acute phase.In combination with MPI,2-DE might provide more comprehensive information for the evaluation of KD. Key words: Mucocutaneous lymph node syndrome;  Coronary disease;  Tomography,emission-computed, single-photon;  Echocardiography;  MIBI