ABSTRACT
Objective@#To investigate the characteristics of long-term changes in giant coronary artery aneurysm (GCAA) caused by Kawasaki disease (KD) and the technical approach of using selective coronary angiography (SCAG) in children.@*Methods@#A retrospective analysis was made in 52 patients with KD and GCAA in acute phase, including 38 males and 14 females with an average age of (4.1±2.5) years old ranging from 1 to 14 years old, from January 2008 to December 2018 at the Department of Cardiology, Guangzhou Women and Children′s Medical Center.The selective coronary angiography (SCAG) was performed in the patients who were followed up for (10.6±3.6) years (1-19 years). The changes in coronary artery lesions were analyzed and the technical approach of SCAG was discussed in children.@*Results@#Among 52 patients investigated by SCAG, the location of coronary artery lesion was found the left-anterior descending branch in 21 cases(40.4%), 20 cases(38.5%) in the right coronary artery, 8 cases(15.4%) in the left main trunk and 3 cases(5.7%) in circumflex.The left coronary artery in 2 cases and the right coronary artery in 4 cases were completely occluded, and collateral vessel formation was found in 12 cases.There were 21 cases of right coronary artery stenosis, including 7 cases of the right coronary artery occlusion and bridge-like neovascularization, and 4 cases of the right coronary artery woven lesions (thrombotic occlusion and clustered neovascularization). There were 27 cases of the left coronary artery stenosis with different degrees, including 5 cases of the left coronary artery occlusion and bridge-like neovascularization, and 2 cases of the left coronary artery woven lesions (thrombotic occlusion and clustered neovascularization). All of 52 patients with GCAA were followed up for 1 to 19 years.GCAA still existed in 40 cases.Regression to small coronary artery aneurysm was found in 8 cases, and mild-dilation regression was observed only in 4 patients.The resting electrocardiogram showed pathological Q wave and the left ventricular enlargement in 6 cases, and normal in the remaining 46 patients.The children had no subjective symptoms and their activities were not restricted.Compared with SCAG, echocardiography detected 52 cases with proximal morphological changes in the coronary artery, but distal changes were found only in 3 cases.And 12 cases with coronary artery occlusion and neovascularization failed to be prompted by echocardiography.@*Conclusions@#GCAA induced by KD can persist for a long time, and has characteristics of coronary occlusion, stenosis, and collateral vessel formation.The conventional electrocardiogram and echocardiography are insensitive to the coronary artery morphology and dysfunction in KD sequelae.The SCAG is of great value in tracking this disease.For using SCAG in children, as long as the approp-riate equipment and projection angle are selected, and the operation skills are mastered, satisfactory images and high success rate can be obtained.
ABSTRACT
Objective To investigate the characteristics of long-term changes in giant coronary artery aneurysm (GCAA) caused by Kawasaki disease (KD) and the technical approach of using selective coronary angiography (SCAG) in children.Methods A retrospective analysis was made in 52 patients with KD and GCAA in acute phase,including 38 males and 14 females with an average age of (4.1 ±2.5) years old ranging from 1 to 14 years old,from January 2008 to December 2018 at the Department of Cardiology,Guangzhou Women and Children's Medical Center.The selective coronary angiography (SCAG) was performed in the patients who were followed up for (10.6 ± 3.6) years (1-19 years).The changes in coronary artery lesions were analyzed and the technical approach of SCAG was discussed in children.Results Among 52 patients investigated by SCAG,the location of coronary artery lesion was found the left-anterior descending branch in 21 cases(40.4％),20 cases(38.5％) in the right coronary artery,8 cases (15.4％) in the left main trunk and 3 cases(5.7％) in cimumflex.The left coronary artery in 2 cases and the right coronary artery in 4 cases were completely occluded,and collateral vessel formation was found in 12 cases.There were 21 cases of right coronary artery stenosis,including 7 cases of the right coronary artery occlusion and bridge-like neovascularization,and 4 cases of the right coronary artery woven lesions (thrombotic occlusion and clustered neovascularization).There were 27 cases of the left coronary artery stenosis with different degrees,including 5 cases of the left coronary artery occlusion and bridge-like neovascularization,and 2 cases of the left coronary artery woven lesions (thrombotic occlusion and clustered neovascularization).All of 52 patients with GCAA were followed up for 1 to 19 years.GCAA still existed in 40 cases.Regression to small coronary artery aneurysm was found in 8 cases,and mild-dilation regression was observed only in 4 patients.The resting electrocardiogram showed pathological Q wave and the left ventricular enlargement in 6 cases,and normal in the remaining 46 patients.The children had no subjective symptoms and their activities were not restricted.Compared with SCAG,echocardiography detected 52 cases with proximal morphological changes in the coronary artery,but distal changes were found only in 3 cases.And 12 cases with coronary artery occlusion and neovascularization failed to be prompted by echocardiography.Conclusions GCAA induced by KD can persist for a long time,and has characteristics of coronary occlusion,stenosis,and collateral vessel formation.The conventional electrocardiogram and echocardiography are insensitive to the coronary artery morphology and dysfunction in KD sequelae.The SCAG is of great value in tracking this disease.For using SCAG in children,as long as the appropriate equipment and projection angle are selected,and the operation skills are mastered,satisfactory images and high success rate can be obtained.
ABSTRACT
A new method is developed to detect vascular edge-line in coronary angiograms.It firstly searches the path through vessel segment of interest,then detects vascular edges along profiles perpendicular to the path.The experiments demonstrate that the method performs well in coronary angiograms with less nearby or overlapping structures and branching vessels.
ABSTRACT
Objective:The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography(DSCT) in the evaluation of coronary artery disease(CAD).Methods:Fifty-two patients(44 male,8 female,mean age 70.59) with a high pre-test probability of CAD underwent DSCT coronary angiography and selective coronary angiography(SCA).Two physicians independently assessed the images of all coronary segments.Results:The overall sensitivity,specificity,positive and negative predictive value for evaluating CAD were 92.31%,99.82%,90.57%,and 99.32%,respectively.Conclusion:The result indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD.And it is a better choice for CAD evaluation.