64层螺旋CT在川崎病冠状动脉病变中的应用价值

目的探讨64层螺旋CT在川崎病冠状动脉病变中的应用价值。方法回顾性分析川崎病20例,所有患者均行64层螺旋CT冠状动脉造影和彩色多普勒超声检查,并对伴有冠状动脉病变患儿进行随访。结果典型川崎病患者15例,其中9例CT和彩色多普勒超声冠状动脉检查均未见异常,5例显示相同(2例左、右冠状动脉扩张,2例冠状动脉瘤形成,1例巨大动脉瘤伴附壁血栓),1例CT示左、右冠状动脉中远段多发瘤样扩张,B超未见明显异常。非典型川崎病患者5例,其中3例CT和B超冠状动脉检查均显示相同(2例冠状动脉瘤,1例双侧冠状动脉增粗迂曲),2例B超未见异常,CT示冠状动脉均有病变(1例冠状动脉瘤,1例冠状动脉狭窄)。结论64层螺旋CT冠状动脉造影对川崎病冠状动脉病变的诊断和随访很有价值。

The Value of 64 -slice Spiral CT in Diagnosis of Kawasaki Disease with Coronary Artery Involvement

Objective To explore the diagnostic value of 64-slice spiral CT for Kawasaki disease with coronary artery involvement.Methods Coronary angiography with 64-slice spiral CT and Doppler color echocardiography were performed in 20 patients with Kawasaki diease.Results Of 15 typical Kawasaki disease,9 cases were normal without coronary artery lesions confirmed by both 64-slice spiral CT scans and Doppler color echocardiography,5 cases were abnormal(left and right coronary arteriae dilatation in 2 cases,coronary artery aneurysm in 2 cases and giant aneurysm with mural thrombosis in 1 case),1 case was clearly showed with ectasia of middle and distal segment of left and right coronary arteriae by CT but not by Doppler color echocardiography.While,of 5 atypical Kawasaki diseases,3 cases had the same results on CT and echocardiograph (aneurysm in 2 and coronary ectasia and meandering in 1),and the remaining 2 cases was only identified by CT but not by echocardiography(coronary aneurysm and stenosis in 1 respectively).Conclusion 64-slice spiral CT coronary artery angiography is of significant value in diagnosing and following up the patient with Kawasaki disease.