The Role of Computed Tomography Coronary Angiography in Kawasaki Disease: Comparison with Transthoracic Echocardiography in a 25-Case Retrospective Study

Although transthoracic echocardiography (TTE) is the first-line examination for the study of coronary lesions in Kawasaki disease, CT coronary angiography (CTCA) is increasingly used and showed good results. Our aim is to evaluate the contribution of CTCA in the detection of coronary lesions and to compare its results with those of TTE. Retrospective study that included 25 patients with Kawasaki disease enrolled in La Rabta University Hospital. The study was conducted over a 4-year period from January 2012 to May 2015. A TTE and a CTCA have been performed for all patients during KD first 3 months of evolution to investigate the coronary artery lesions. There were 23 lesions described on CTCA and not diagnosed with TTE: there were 16 aneurysms, 6 ectasia and 1 case of stenosis. The lesions concerned: LCX in eight cases, RCA in eight cases, LMCA in three cases, and LAD and PDA in two cases each. Differences of description between TTE and CTCA were identified in 14 cases. These discrepancies concerned the type of lesion in seven cases (50%), the size of the aneurysm in five cases (35%) and the shape of the aneurysm in two cases. The CTCA showed its superiority in detecting coronary lesions in our series especially fusiform ones and those interesting distal and posterior network. However, because of its radiating character and its availability, TTE should remain the fist-line examination.