Objective: To evaluate the feasibility of low dose computed tomography coronary angiography (CTCA) on a dual source scanner in children on follow up for Kawasaki disease (KD).
Methods: A prospective study comprising 20 consecutive children with KD was conducted from November 2013 to August 2014 on 128-dual source second generation Siemens Definition Flash with either prospective or retrospective electrocardiographic (ECG) gating. A radiologist blinded to the clinical profile and echocardiography (ECHO)/ stress thallium data evaluated each scan. Peak Kilovolts (KVp), milliampere (mA) and radiation dose (dose length product-mGycm and effective dose milliSieverts-mSv) were recorded. Another radiologist correlated CTCA data with clinical/ other imaging data.
Results: Demographic/ clinical data and scan parameters are given in Table. Mean effective dose was 1.25 mSv (range 0.22 to 2.74), with prospective ECG gating in 8 patients, it was even lower (0.22 to 0.91 mSv). Six of the 20 patients showed abnormalities including ectasia (n=3), aneurysm (n=2) and stenosis (n=3). More than one abnormality was seen in 2 patients. Four children with normal ECHO had abnormalities detected on CTCA. Stress thallium scintiscan had been performed in 16 patients with mild/ moderate reversible perfusion defects detected in 14. Six of 14 patients with moderate perfusion abnormalities had an abnormal CTCA.
Conclusion: In our experience, dual source CTCA is a feasible low radiation dose modality in evaluation in patients with KD.
Future impact: Dual source CTCA has potential to be standard of care for evaluation of coronary artery abnormalities in KD.