Imaging
RAKESH KUMAR PILANIA, MBBS, MD (Ped), DM (Pediatric Clinical Immunology and Rheumatology), MAMS, Assoc FAMS, Assoc FINSA
Assistant Professor
Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, PGIMER, Chandigarh
Chandigarh, Chandigarh, India
Background: Coronary artery abnormalities (CAAs) of KD mandate long-term follow-up. CAAs can be complicated by calcification, thromboses, and/or stenoses. Computed Tomography Coronary angiography (CTCA) on present-day CT scanners with radiation optimization capabilities has enabled the comprehensive evaluation of coronary arteries. This study pertains to CTCA performed during follow-up in 12 patients with calcifications in CAAs.
Methods: This study was carried out in the Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, from 2014 to 2024. Diagnosis of KD was based on standard criteria. CTCA was carried out on dual-source CT scanners: 128-detectors Definition Flash/194-detectors-Force (Siemens, Erlangen, Germany). We have carried out CTCA in 197 KD patients during follow-up. Calcifications were noted in 21 arteries in 12 patients.
Results: There were 10 boys and 2 girls in this cohort. The mean age at occurrence of KD was 4 years (range 2 months - 8 years). The most common artery involved in calcification was the Left anterior descending artery (12 calcifications), followed by the right coronary artery (7 calcifications). The left main coronary artery was involved in 2 patients. No calcification was seen in the left circumflex artery. Three patients revealed a thrombus in LAD. Two patients had stenosis in LAD, while one patient had stenosis in RCA.
Conclusions: Children with KD and CAA require prospective long-term follow-up as they may develop complications like calcifications, thromboses, and stenoses. CTCA provides a more detailed and comprehensive evaluation of calcifications. this is the first study of its kind from the Indian subcontinent.