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Tomographic Myocardial Perfusion Scintigraphy in Children with Kawasaki Disease

Departments of Nuclear Medicine, Cardiology, and Pediatric Cardiology, University Hospital, Hamburg, FRG

Correspondence: For reprints contact: R. P. Spielmann, MD, Dept. of Nuclear Medicine, Universitaetskrankenhaus Eppendorf, Martinistrasse 52,2000 Hamburg 20, West Germany.

ABSTRACT

Myocardial infarction and stenotic coronary lesions are serious late complications in children with Kawasaki disease. For the noninvasive assessment of myocardial perfusion, dipyridamole-redistribution ²⁰¹Tl emission computed tomography (ECT) was performed in seven children (age 2 8/12–8 7/12 yr) 3–20 mo after the acute stage of the disease. In all patients, coronary aneurysms had been demonstrated by cross-sectional echocardiography. The scintigrams of six children showed no significant regional reduction of myocardial thallium uptake. These children had remained asymptomatic since the acute stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with documented myocardial infarction. For this patient, obstruction of corresponding coronary vessels was confirmed by contrast angiography. It is suggested, that ²⁰¹Tl ECT after dipyridamole-induced vasodilation may be used as a safe alternative to invasive coronary angiography for follow-up investigations in patients with Kawasaki disease.

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