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Assessment of coronary ischaemia by myocardial perfusion dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography, and coronary angiography in children with Kawasaki disease: pre- and post-coronary bypass grafting

Published online by Cambridge University Press:  05 August 2014

Mostafa S. Mostafa ,
Ashraf O. Sayed  and
Yasser M. Al Said
Mostafa S. Mostafa
Affiliation:
Department of Nuclear medicine, Assiut University, Egypt
Ashraf O. Sayed*
Affiliation:
Department of Pediatrics, Children and Women’s University Hospital, Minia University, P.O. Box 61519, El-Minia, Egypt
Yasser M. Al Said
Affiliation:
Department of Nuclear Medicine, Cairo University, Egypt
*
Correspondence to: Dr. A. O. Sayed, Department of Pediatrics, Children and Women’s University Hospital, Minia University, P.O. Box 61519, El-Minia, Egypt. Tel: +965 66486724; Fax: +2 086 2342813; E-mail: asoayed1@yahoo.com.
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Abstract

Background: Coronary artery lesions in Kawasaki disease invasively assessed by coronary angiography. Evaluation of myocardial perfusion by single-photon emission computed tomography may identify the haemodynamic significance of coronary lesions. Objective: To evaluate diagnostic accuracy of dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography as a possible alternative to invasive coronary angiography for detection and follow-up of myocardial ischaemia in patients with Kawasaki disease, and pre- and post-coronary bypass grafting. Patients and methods: Coronary angiography and single-photon emission computed tomography were performed on 21 patients who were classified into three groups – group I (stenosis), group II (giant aneurysms), and group III (small aneurysms). Of the 21 patients, 16 (groups I and II) patients with myocardial perfusion defects, who underwent coronary bypass grafting, were followed up with single-photon emission computed tomography. Result: In group I, all patients had significant coronary stenosis and 100% of them had perfusion defects in the anterior and septal walls. In group II, all patients had giant aneurysms and 83% of them had inferior and inferolateral perfusion defects. In group III, all patients had small aneurysms and 100% of them had normal perfusion. Pre-coronary bypass grafting myocardial ischaemic defects disappeared in all patients after surgery. Sensitivity, specificity, and accuracy of single-photon emission computed tomography were 94, 100, and 95%, respectively. Conclusion: Technetium-99 m tetrofosmin single-photon emission computed tomography can be applied as an accurate non-invasive diagnostic technique for detecting myocardial perfusion defects with coronary artery lesions, and to show improved or even normalised perfusion of the myocardium in patients after surgical revascularisation.

Keywords

Kawasaki diseasecoronary angiographysingle-photon emission computed tomography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 927 - 934
Copyright
© Cambridge University Press 2014 

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