Key result
Dipyridamole stress technetium-99m tetrofosmin SPECT accurately detected myocardial perfusion defects in children with Kawasaki disease, demonstrating 94% sensitivity and 100% specificity.
Why the study?
Does dipyridamole stress technetium-99m tetrofosmin SPECT accurately detect myocardial ischemia compared to invasive coronary angiography in children with Kawasaki disease?
Observational (n=21)
Does dipyridamole stress technetium-99m tetrofosmin SPECT accurately detect myocardial ischemia compared to invasive coronary angiography in children with Kawasaki disease?
Technetium-99m tetrofosmin SPECT is a highly accurate non-invasive alternative to coronary angiography for detecting myocardial ischemia and assessing post-surgical revascularization in children with Kawasaki disease.
Answers are grounded in this paper and cite their sources.
Supports non-invasive SPECT for ischemia detection in pediatric Kawasaki disease; leaves open prospective validation before changing practice.
BACKGROUND: Coronary artery lesions in Kawasaki disease invasively assessed by coronary angiography. Evaluation of myocardial perfusion by single-photon emission computed tomography may identify the haemodynamic significance of coronary lesions. OBJECTIVE: To evaluate diagnostic accuracy of dipyridamole stress technetium-99 m tetrofosmin, single-photon emission computed tomography as a possible alternative to invasive coronary angiography for detection and follow-up of myocardial ischaemia in patients with Kawasaki disease, and pre- and post-coronary bypass grafting. PATIENTS AND METHODS: Coronary angiography and single-photon emission computed tomography were performed on 21 patients who were classified into three groups - group I (stenosis), group II (giant aneurysms), and group III (small aneurysms). Of the 21 patients, 16 (groups I and II) patients with myocardial perfusion defects, who underwent coronary bypass grafting, were followed up with single-photon emission computed tomography. RESULT: In group I, all patients had significant coronary stenosis and 100% of them had perfusion defects in the anterior and septal walls. In group II, all patients had giant aneurysms and 83% of them had inferior and inferolateral perfusion defects. In group III, all patients had small aneurysms and 100% of them had normal perfusion. Pre-coronary bypass grafting myocardial ischaemic defects disappeared in all patients after surgery. Sensitivity, specificity, and accuracy of single-photon emission computed tomography were 94, 100, and 95%, respectively. CONCLUSION: Technetium-99 m tetrofosmin single-photon emission computed tomography can be applied as an accurate non-invasive diagnostic technique for detecting myocardial perfusion defects with coronary artery lesions, and to show improved or even normalised perfusion of the myocardium in patients after surgical revascularisation.
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Mostafa et al. (2014) conducted an observational in Kawasaki disease with coronary artery lesions (n=21). Dipyridamole stress technetium-99m tetrofosmin SPECT vs. Invasive coronary angiography was evaluated on Diagnostic accuracy for detection of myocardial ischaemia. Dipyridamole stress technetium-99m tetrofosmin SPECT accurately detected myocardial perfusion defects in children with Kawasaki disease, demonstrating 94% sensitivity and 100% specificity.
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