Giant coronary aneurysm in a toddler with Kawasaki disease: technical challenges in CT coronary angiography

Kawasaki disease is the most common vasculitis causing acquired coronary artery aneurysm (CAA) and affects mostly children. Computed tomography coronary angiography (CTCA) has unique diagnostic and prognostic values in cases of giant CAA. Here, we report technical challenges encountered when perform...

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Bibliographic Details
Published in:BJR case reports 2024-01, Vol.10 (1), p.uaad008
Main Authors: Chan, Yan Hei, Young, Catherine Yee Man, Wang, Ki, So, Enoch C T, Chu, Winnie C W
Format: Article
Language:English
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Case Report
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Summary:Kawasaki disease is the most common vasculitis causing acquired coronary artery aneurysm (CAA) and affects mostly children. Computed tomography coronary angiography (CTCA) has unique diagnostic and prognostic values in cases of giant CAA. Here, we report technical challenges encountered when performed CTCA for a case of Kawasaki disease complicated with giant CAA. In particular, there was significant flow alteration caused by the giant CAA(s) causing suboptimal enhancement when the standard protocol was applied. We share our experience in optimizing the scan and propose the use of either manual bolus tracking or test bolus technique in similar scenarios, as well as multidisciplinary approach to optimize patient preparation.
ISSN:2055-7159
2055-7159
DOI:10.1093/bjrcr/uaad008