Singhal M, Pilania RK, Gupta P, Johnson N, Singh S. Emerging role of computed tomography coronary angiography in evaluation of children with Kawasaki disease. World J Clin Pediatr 2023; 12(3): 97-106 [PMID: 37342454 DOI: 10.5409/wjcp.v12.i3.97]
Corresponding Author of This Article
Manphool Singhal, MBBS, MD, DNB, FSCCT, FSCMR, Professor, Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Madhya Marg, Sector 12, Chandigarh 160012, Chandigarh, India. drmsinghal74@gmail.com
Research Domain of This Article
Rheumatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Manphool Singhal, Pankaj Gupta, Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Chandigarh, India
Rakesh Kumar Pilania, Nameirakpam Johnson, Surjit Singh, Pediatric Allergy Immunology Unit, Department of Paediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Chandigarh, India
Author contributions: Singhal M and Pilania RK contributed equally and shared the first authorship. Singhal M and Pilania RK designed the research, written first draft, review of literature, editing of manuscript and critical revision of manuscript at all stages; Gupta P and Johnson N contributed in literature review and editing of the manuscript; Singh S review of literature, editing of manuscript, critical revision of manuscript at all stages. Singhal M and Pilania RK are joint first authors.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manphool Singhal, MBBS, MD, DNB, FSCCT, FSCMR, Professor, Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Madhya Marg, Sector 12, Chandigarh 160012, Chandigarh, India. drmsinghal74@gmail.com
Received: March 4, 2023 Peer-review started: March 4, 2023 First decision: April 13, 2023 Revised: May 8, 2023 Accepted: May 22, 2023 Article in press: May 22, 2023 Published online: June 9, 2023
Abstract
Coronary artery abnormalities are the most important complications in children with Kawasaki disease (KD). Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with KD. However, it has inherent limitations with regard to evaluation of mid and distal coronary arteries and, left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age group. Catheter angiography (CA) is invasive, has high radiation exposure and fails to demonstrate abnormalities beyond lumen. The limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these problems. In recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in children. Computed tomography coronary angiography (CTCA) can be performed during acute as well as convalescent phases of KD. It is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.
Core Tip: In recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in children. Computed tomography coronary angiography (CTCA) can be performed during acute as well as convalescent phases of Kawasaki disease (KD). It is likely that CTCA may soon be considered the gold standard imaging modality for evaluation of coronary arteries in children with KD.
