Follow up Findings of Dipyridamole Stress 99mTc-tetrofosmin Scintigraphy in Patients with Kawasaki Disease

Abstract

Some types of coronary aneurysms resulting from Kawasaki disease may regress, but some take a malignant course, leading to stenotic and obstructive lesions. It is sometimes difficult to monitor progressive changes from aneurysm to stenotic lesions because coronary angiography (CAG) cannot be repeated very often. From November 1994 through December 2000, we procedure the dipyridamole stress 99mTc-tetrofosmin (Tf) single photon emission computed tomography (SPECT) for 70 patients to 105 times. Twenty patients were followed with Tf-SPECT at least 1 year. Extent and severity scores were calculated. CAG was performed all within 3 month of Tf-SPECT. These 20 patients were divided into two groups. Group I, to 9 consisted of patients with persistent coronary stenosis, including one patient with the progression of the coronary stenosis from previous coronary aneurysm and one patient who had coronary artery bypass graft surgery (CABG). Group II, to 11 patients with persistent coronary aneurysm. In Group I, seven patients revealed ischemic findings at any stage. One patient who had progression of the coronary stenosis from coronary aneurysm did not reveal ischemic change in the aneurysmal stage, but stenotic stage revealed ischemic findings. The other patient, who had coronary artery bypass graft surgery, pre- CABG finding of Tf-SPECT revealed ischemic change but disappear ischemic finding after CABG. In Group II, they did not reveal ischemic findings. One patient who progress coronary stenosis, Tf-SPECT findings and severity score progress to accompany with coronary stenosis. This noninvasive technique may become one of the most useful method to monitor progressive changes of myocardial ischemia in Kawasaki disease.