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Congenital anomalies of coronary artery misdiagnosed as coronary dilatations in Kawasaki disease:A clinical predicament

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World Journal of Clinical Pediatrics 2025年第1期14卷 93-100页

作者： Rakesh Kumar Pilania Pallavi L Nadig Suprit Basu Reva Tyagi Abarna Thangaraj Ridhima Aggarwal Munish Arora Arun Sharma Surjit Singh Manphool Singhal Pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CenterPost Graduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia

BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary *** To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities(CAAs)on *** Records of children diagnosed with KD,who underwent computed tomography coronary angiography(CTCA)at our center between 2013-2023 were *** identified 3 children with congenital coronary artery anomalies in this cohort on *** of CTCA and 2DE were compared in these 3 *** Of the 241 patients with KD who underwent CTCA,3(1.24%)had congenital coronary artery anomalies on CTCA detected *** all 3 patients,baseline 2DE had identified *** was then performed for detailed evaluation as per our unit ***(11-year-boy)amongst the 3 patients had complete KD,while the other two(3.3-year-boy;4-month-girl)had incomplete *** revealed separate origins of left anterior descending artery and left circumflex from left sinus[misinterpreted as dilated left main coronary artery(LCA)on 2DE],single coronary artery(interpreted as dilated LCA on 2DE)and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary *** latter one was subsequently operated *** CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery *** solely on 2DE may not be sufficient in such cases,and findings from CTCA can significantly impact therapeutic decision-making.

关键词： coronary artery abnormalities Congenital coronary artery anomalies Computed tomography coronary angiography Kawasaki disease 2-dimensional echocardiography

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Radiation dose analysis of computed tomography coronary angiography in Children with Kawasaki disease

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World Journal of Clinical Pediatrics 2023年第4期12卷 230-236页

作者： Mahesh Chandra Bhatt Manphool Singhal Rakesh Kumar Pilania Subhash Chand Bansal Niranjan Khandelwal Pankaj Gupta Surjit Singh Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePost Graduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing *** To audit the radiation dose of CTCA in children with *** Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective *** dose length product(DLP in ***)was *** radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological *** dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent *** median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 ***,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)*** DLP increased significantly across the age *** effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of *** the CTCA studies were of diagnostic *** child required a repeat *** CTCA is feasible with submillisievert radiation dose in most children with ***,CTCA has the potential to be an important adjunctive imaging modality in children with KD.

关键词： Computed tomography coronary angiography coronary artery abnormalities Dual source computed tomography Kawasaki disease Radiation exposure

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Emerging role of computed tomography coronary angiography in evaluation of children with Kawasaki disease

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World Journal of Clinical Pediatrics 2023年第3期12卷 97-106页

作者： Manphool Singhal Rakesh Kumar Pilania Pankaj Gupta Nameirakpam Johnson Surjit Singh Departments of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012ChandigarhIndia Pediatric Allergy Immunology Unit Department of PaediatricsAdvanced Pediatrics CenterPostgraduate Institute of Medical Education and ResearchChandigarh 160012ChandigarhIndia

coronary artery abnormalities are the most important complications in children with Kawasaki disease(KD).Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with ***,it has inherent limitations with regard to evaluation of mid and distal coronary arteries and,left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age *** angiography(CA)is invasive,has high radiation exposure and fails to demonstrate abnormalities beyond *** limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these *** recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in *** tomography coronary angiography(CTCA)can be performed during acute as well as convalescent phases of *** is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.

关键词： coronary artery abnormalities Computed tomography coronary angiography 2D-echocardiography Kawasaki disease Imaging modality Acquired heart disease

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