Long-Term Coronary Artery Evaluation Using Noncontrast-Enhanced Magnetic Resonance Angiography in Patients with Kawasaki Disease.

Abstract

To evaluate the use of noncontrast-enhanced coronary magnetic resonance angiography (NC-CMRA) for long-term follow-up in patients with Kawasaki disease (KD). In total, 40 (77 aneurysms) patients with KD who underwent NC-CMRA were retrospectively analyzed. Coronary artery aneurysms and dilations observed during the acute phase were classified into three groups according to their diameter based on the American Heart Association criteria. The prevalence of coronary artery stenotic lesions was evaluated using the Kaplan-Meier method (log-rank test). The agreement in the coronary artery stenosis rates between NC-CMRA and coronary angiography (CAG) was examined via Brand-Altman analysis and intraclass correlation coefficients (ICC). In patients with large or giant aneurysms, the prevalence of coronary artery stenotic lesions was 26.3% at 10 years, 53.2% at 15 years, and 71.9% at 20 years. In patients with medium aneurysms, the prevalence of coronary artery stenotic lesions was 8.4% at 10 and 15 years and 23.7% at 20 years. Patients with small aneurysms did not exhibit stenotic lesions. Patients with large or giant aneurysms had significantly higher rate of coronary stenotic lesions than those with medium and small aneurysms (p < 0.05). All 16 stenotic lesions detected on NC-CMRA were consistent with those observed on CAG, and the coronary artery stenotic rate had moderate consistency (ICC 0.65). In KD, the detection of coronary artery stenosis using NC-CMRA was consistent with that using CAG. Therefore, NC-CMRA can be a better alternative following echocardiography for long-term coronary artery evaluation in patients with KD.