Pitfall for systemic artery aneurysms evaluation using electrocardiogram-gated subtracted three-dimensional fast spin echo sequence of magnetic resonance imaging in patients with Kawasaki disease

• Published in: Radiology case reports 2022-05, Vol.17 (5), p.1440-1444
• Main Authors: Nonaka, Haruki, Masuda, Takanori, Yoneyama, Masami, Tahara, Masahiro, Okano, Mio, Morikawa, Yuko, Sanada, Kazuya, Sato, Tomoyasu
• Format: Article
• Language: English
• Subjects: Case Report; Electrocardiogram-gated subtracted three-dimensional fast spin echo; Kawasaki disease; Magnetic resonance imaging; Non-contrast magnetic resonance angiography; Systemic artery aneurysms
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2022.01.083

Kawasaki disease (KD) is described as a syndrome that causes both coronary and systemic artery aneurysms (SAAs). This report describes the pitfall for SAAs’ evaluation when using electrocardiogram (ECG)-gated subtracted three-dimensional fast spin echo (3D FSE) sequence of magnetic resonance imaging in KD patients. A 12-year-old male was diagnosed with KD at 3 months of age. We acquired ECG-gated 3D FSE images in the diastole and systole phases with coronal sections. Subtraction was then performed from diastolic phase imaging to systolic phase imaging. A 15.5 mm right axillary artery aneurysm and an 8.0 mm left axillary artery aneurysm were identified with ECG-gated 3D FSE in the diastolic phase. However, we observed signal loss in the right axillary artery aneurysm when subtraction was performed to selectively detect arteries; further, the brachial artery was poorly detected. ECG-gated subtracted 3D FSE sequence of magnetic resonance imaging can compromise the image quality of both aneurysm and peripheral artery images when detecting SAAs.