Discordance between dipyridamole technetium-99m-sestamibi myocardial perfusion single photon emission computed tomography and two-dimensional echocardiography in Kawasaki disease--a preliminary report

Abstract

This study attempts to establish a noninvasive diagnostic method for early assessment of cardiac involvement in Kawasaki disease (KD), 36 children with KD were studied. The presence of abnormal coronary arteries (CA) with aneurysms was determined by experienced pediatric cardiologists using two-dimensional echocardiography (2D-Echo). Rest and dipyridamole-stress technetium-99m sestamibi (Tc-MIBI) single photon emission computed tomography (SPECT) was performed on the 36 children with KD for the assessment of myocardial perfusion and for comparison with 2D-Echo findings. The results showed that (1) 17/36 (47.2%) of the cases had no aneurysm and 19/36 (52.8%) had significant aneurysms; (2) 16/36 (44.4%) of the cases had normal myocardial perfusion and 20/36 (55.6%) had myocardial perfusion defects; (3) 9/36 (25.0%) cases showed both normal 2D-Echo and Tc-MIBI SPECT findings and 12/36 (33.3%) showed both abnormal 2D-Echo and Tc-MIBI SPECT findings; and (4) There was poor agreement between 2D-Echo and Tc-MIBI SPECT findings (kappa-value = 0.161, p = 0.332). We concluded that the most of the KD children had aneurysms or abnormal myocardial perfusion. However, poor agreement exists between 2D-Echo and Tc-MIBI SPECT findings with aneurysms and abnormal myocardial perfusion in patients with KD.