Diagnosis of Atypical Kawasaki Diseases in Early Stage by Echocardiography

Abstract

Objective: To improve the diagnostic ability of atypical Kawasaki Diseases in early stage. Methods: Two-dimensional echocardiographic features of 24 cases with atypical Kawasaki disease in last two years were analyzed in retrospect. All the children in our study only have 3 or 4 items in the diagnostic standard revised by Japanese MCLS Research Committee in 1984. ATL HDI 5000 and/or HP 5500 color Doppler ultrasound system with transducer frequency of 3∼8 MHz were used to scan the sick children. The internal diameter and shape of coronary arteries were focused in the following views: short axis of aorta, short axis of LV at mitral level, atypical longistudinal view of LV, longistudinal view of right ventricular inlet and outlet view, et al. The qualification of coronary dilatation was classified according to the “Guidelines for coronary lesion in KD” reported by Kato, based on the changes of coronary artery in coronary angiography. Results: Four kinds of two-dimensional echocardiographic features of Kawasaki diseases are described as follow. (1) Normal coronary arteries in diameter with thickening arterial wall, enhancing wall echo, and blurred internal cavity. (2) Stenosis of coronary arteries with thickening arterial wall and enhancing wall echo. (3) Slight dilation of coronary arteries with thickening arterial wall and enhancing wall echo. (4) Severe dilation of coronary arteries and coronary aneurysms developed. Conclusion: Echocardiography is of great values in diagnosing Kawasaki disease at early stage of Kawasaki disease, which plays an important role in releasing coronary arteries injure.