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Editorial
CT coronary angiography in Kawasaki disease: current perspectives
  1. Manphool Singhal1,
  2. Rakesh Kumar Pilania2,
  3. Suprit Basu2,
  4. Arun Sharma1,
  5. Surjit Singh2
  1. 1Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Manphool Singhal; drmsinghal74{at}gmail.com

https://doi.org/10.1136/archdischild-2024-327190

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    Introduction

    Kawasaki disease (KD) is a common vasculitic disorder in children that preferentially involves the coronary arteries.1 Coronary artery abnormalities (CAAs) may develop in 15–25% of patients with KD who do not get timely treatment. However, even with appropriate treatment, CAAs can still develop in ~5% of patients.1 Precise diagnosis of CAAs is important for treatment planning.1–3

    CAAs are the most important complication of KD and necessitate prompt and accurate diagnosis. While CAAs are more common in proximal segments, these can also occur distally.1–3 Presence of CAAs in both distal and proximal segments of coronary arteries impacts treatment planning. With time, CAAs may resolve, remodel or persist and may be complicated by thrombosis, steno-occlusive lesions and mural calcifications.1–3

    There are several imaging techniques for assessment of CAAs. These include 2D-transthoracic echocardiography (2DE), catheter coronary angiography (CCA), magnetic resonance coronary angiography (MRCA) and CT coronary angiography (CTCA).

    Role of 2DE in KD

    2DE is a simple, non-invasive point-of-care test for detection of CAAs. It is useful for detection of aneurysms in proximal segments of coronary arteries.1 However, there are several limitations of 2DE. These include operator dependency and interobserver variability, poor acoustic window in older children and difficulty in detection of CAAs in (1) mid and distal segments, (2) coronary artery branches and (3) left circumflex artery. …

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    Footnotes

    • Contributors MS, RKP and SS conceptualised and designed the study. SB and RKP drafted the initial manuscript, conducted a detailed literature review and revised the manuscript. AS provided a critical review and revision of the manuscript. MS and SS supervised the writing process, provided a critical review and revision of the manuscript and gave final approval. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.