Myocaridal Scintigraphy with 99mTc-Sestamibi in Patients with Kawasaki Disease

Abstract

To verify the usefulness of a semi-invasive assessment of myocardial perfusion, rest and dipyridamole 99mTc-Sestamibi scintigraphy were performed on 62 patients (19 females and 43 males) with Kawasaki disease. Their ages at the onset of Kawasaki disease ranged from 3 months to 10 years. The nuclear medicine study was performed at the age of 3.5 months to 18 years (6.5±5.3 years); they were 0.5 month to 17 years after the onset of illness. Among them, coronary arterial dilatation had been detected by two-dimensional echocardiography in 9 patients. Four of them were also demonstrated by cardiac catheterization. Seven of them with coronary arterial lesions showed 99mTc-Sestamibi scintigraphic abnormalities. Perfusion defects were also detected in 18 of 53 patients (false positive rate 34.0%) with normal coronary arteries on echocardiography or cineangiography. The sensitivity, specificity, positive and negative predictive value of 99mTc-Sestamibi scintigraphy for detection of myocardial dysfunction which may indicating coronary arterial lesions were 77.8% (7/9), 66.0% (35/53), 28% (7/25) and 94.6% (35/37). The higher negative predictive value (94.6%) and sensitivity (77.8%) suggest that rest and dipyridamole 99mTc-Sestamibi scintigraphy is an useful and semi-invasive method for detecting coronary arterial insufficiency and long-term follow-up study of patients with Kawasaki disease.