J Korean Pediatr Soc.  1999 Feb;42(2):211-220.

Assessment of Myocardial Ischemia using Myocardial Perfusion Scan in Kawasaki Disease

• Gil HR
• Choi JY
• Yoon MJ
• Park SS
• Kim HS
• Noh CI
• Yoon YS
• Lee MC
• Lee DS

Abstract

PURPOSE: Myocardial scintigraphy has been reported to be useful in adults, but its usefulness in children is limited. This study was done to determine the feasibility and accuracy of 99mTc-MIBI SPECT(sestamibi , methoxy-isobutyl-isonitrarite myocardial single emirs sion computed tomography, Dp-SPECT) after dipyridamole infusion to detect coronary obstructive lesions in Kawasaki disease(KD).
METHODS
Dp-SPECT was performed in 21 control(group 1), 8 with coronary aneurysm(group 2) and 16 with coronary obstructive lesion(group 3) in children with KD. The spatial distribution of Dp-SPECT was determined and analyzed visually. Group 2 and 3 underwent coronary angiogram within 3 months of Dp-SPECT.
RESULTS
Chest pain occurred more frequently in group 2. No subject required supplemental oxygen or were complicated by myocardial ischemia. The specificity of Dp-SPECT for control subject was 95% & 62% if using a cut-off criterion of abnormality, utilizing moderate or mild perfusion defect, respectively. The false positive rate was high in anterior, apical and anteroseptal segments but not related to age. The abnormalities found on Dp-SPECT was observed in 25% of aneurysmal coronary arteries but not related to its size. The sensitivity, specificity, and accuracy of Dp-SPECT was 100%, 84.5% and 79% in coronary stenosis greater than 75%, respectively.
CONCLUSION
The interpretation of Dp-SPECT should be careful in KD because of discrepancies between Dp-SPECT & angiography, But DP-SPECT is noninvasive and easily applicable. It monitors the occurrence and progression of coronary stenosis due to KD. Besides Dp-SPECT may be applicable after arterial switch operation or to myocardial sinusoid.

MeSH Terms

Adult
Aneurysm
Angiography
Chest Pain
Child
Coronary Stenosis
Coronary Vessels
Dipyridamole
Humans
Mucocutaneous Lymph Node Syndrome*
Myocardial Ischemia*
Myocardial Perfusion Imaging
Oxygen
Perfusion*
Sensitivity and Specificity
Dipyridamole
Oxygen