Multidetector-row computed tomography diagnosis of coronary artery aneurysms and collateral vessel after Kawasaki disease in an adult

Abstract

A 54-year-old man was referred to our hospital for assessment of an oval calcified mass in the left middle mediastinum on a chest X-ray (Fig. 1). He had an episode of high-grade fever persisting for 10 days when he was 4 years old, but otherwise healthy ever since. His electrocardiogram was normal. Multidetector-row computed tomography (MDCT) was performed with the provisional diagnosis of coronary artery aneurysm. MDCT was performed using an Aquillion 16 (16-detector-row, Toshiba, Japan) with a collimation of 0.5 mm, table feed of 3.2 mm/rotation, 120 kV, 400 mA, and gantry rotation time of 0.4 s. Our scan protocol and image reconstruction method have been reported previously [1]. Metoprolol (40 mg) was given 90 min prior to the scan. Following determination of contrast transit time from the venous injection to the maximum enhancement in the ascending aorta by injecting 15 ml of nonionic contrast medium (Iomeron 350, 100 ml syringe, Eisai, Tokyo, Japan), the remaining contrast medium (85 ml) was injected at a speed of 3.5 ml/s. The heart rate immediately before the scan