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. 2021 Jun 30:9:670887.
doi: 10.3389/fped.2021.670887. eCollection 2021.

The Complementary Relationship Between Echocardiography and Multi-Slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Artery Thrombosis in Children With Kawasaki Disease

Yun-Ming Xu  1 , Yan-Qiu Chu  1 , Xue-Mei Li  1 , Ce Wang  1 , Quan-Mei Ma  2 , Xiao-Na Yu  3 , Xian-Yi Yu  1 , Rui Chen  1 , Yan-Lin Xing  1 , Xue-Xin Yu  1 , Le Sun  1 , Xiao-Zhe Cui  1 , Hong Wang  1
Affiliations

The Complementary Relationship Between Echocardiography and Multi-Slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Artery Thrombosis in Children With Kawasaki Disease

Yun-Ming Xu et al. Front Pediatr. .

Abstract

Aim: To compare the diagnostic values by using transthoracic echocardiography (ECHO) and multi-slice spiral CT coronary angiography (CTCA) for identifying coronary artery thrombosis in children with Kawasaki disease (KD). Methods: Total 97 KD children with coronary artery dilation complications in our hospital from June 2012 to December 2020 were included in the study. CTCA and ECHO were performed after over 1 month of illness. Results: Coronary artery thrombosis was found in 14 out of 97 patients. Among them, 10 were identified as positive by CTCA, 9 were identified as positive by ECHO, and 5 were identified as positive by both CTCA and ECHO. Conclusion: Both CTCA and ECHO can be used to diagnose coronary artery thrombosis. ECHO has advantage in identifying low-density thrombus, and CTCA is better for the clot in distal coronary artery. They can complement each other.

Keywords: CTCA; Kawasaki disease; children; coronary artery lesion; echocardiography; thrombosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The thrombosis was detected by ECHO at 19 days (a) and 22 days (c) of illness in case 1 but wasn't detected by CTCA (b) at 18 days of illness.
Figure 2
Figure 2
The ECG showed downward ST segment and flat T wave (a). Thrombosis (arrow) was detected at distal RCA by CTCA (c) in case 2 at about 6.5 months of illness, whereas it wasn't detected by ECHO 2 days before and 1 day after (b) CTCA.
Figure 3
Figure 3
The legend needs modification. The effect of thrombosis on myocardial function and survival in patients with Kawasaki disease. There was significant difference of prognosis in groups with thrombosis or not (p = 0.000).
Figure 4
Figure 4
In case 4, the thrombosis was detected by ECHO (a) 2 days before CTCA but wasn't detected by CTCA (b) at about 6.5 years of illness.
See this image and copyright information in PMC

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