MRA of the chest and abdomen is more useful to CTA due to its ability to interrogate a wider vascular territory for screening for aneurysms in the setting of Kawasaki disease [34]. CTA Coronary Arteries CTA of coronary arteries is currently the most useful imaging modality for evaluating coronary arteries. Virtual angioscopic view of coronary CTA helps to evaluate anatomic high-risk features, such as the slit-like morphology of the ostium [35]. CT can identify other anatomic high-risk features, such as acute take-off angle, luminal shape, and proximal narrowing of the anomalous coronaries related to the intramural and interarterial course [35]. Coronary CTA, overall, provides a more accurate depiction of the entire anomalous vessel including the distal coronary segments. Coronary CTA is also useful in the setting of Kawasaki disease to screen for the presence and extent of coronary involvement by ectasia, aneurysm, or stenosis and to diagnose and follow-up the presence of mural thrombus in larger aneurysms. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT in the evaluation of suspected or confirmed congenital or acquired coronary artery abnormality. MRA Abdomen MRA abdomen is used to screen for extracardiac involvement in Kawasaki disease, with iliac aneurysms being a common manifestation of the disease. MRA Chest MRA chest allows 3-D reconstruction visualization of coronary artery origin and proximal course in AAOCA and the presence of coronary aneurysms in Kawasaki disease, but its spatial resolution is inferior to that of coronary CTA. MRA using 3-D steady-state free precession or 3-D fast gradient echo techniques can be used to evaluate the proximal coronary in AAOCA or the coronary tree in Kawasaki disease. MRA may also be performed with intravenous (IV) contrast to assess the systemic arterial tree for evidence of extracardiac aneurysms in Kawasaki disease [36-38].
Congenital or Acquired Heart Disease. MRA of the chest and abdomen is more useful to CTA due to its ability to interrogate a wider vascular territory for screening for aneurysms in the setting of Kawasaki disease [34]. CTA Coronary Arteries CTA of coronary arteries is currently the most useful imaging modality for evaluating coronary arteries. Virtual angioscopic view of coronary CTA helps to evaluate anatomic high-risk features, such as the slit-like morphology of the ostium [35]. CT can identify other anatomic high-risk features, such as acute take-off angle, luminal shape, and proximal narrowing of the anomalous coronaries related to the intramural and interarterial course [35]. Coronary CTA, overall, provides a more accurate depiction of the entire anomalous vessel including the distal coronary segments. Coronary CTA is also useful in the setting of Kawasaki disease to screen for the presence and extent of coronary involvement by ectasia, aneurysm, or stenosis and to diagnose and follow-up the presence of mural thrombus in larger aneurysms. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT in the evaluation of suspected or confirmed congenital or acquired coronary artery abnormality. MRA Abdomen MRA abdomen is used to screen for extracardiac involvement in Kawasaki disease, with iliac aneurysms being a common manifestation of the disease. MRA Chest MRA chest allows 3-D reconstruction visualization of coronary artery origin and proximal course in AAOCA and the presence of coronary aneurysms in Kawasaki disease, but its spatial resolution is inferior to that of coronary CTA. MRA using 3-D steady-state free precession or 3-D fast gradient echo techniques can be used to evaluate the proximal coronary in AAOCA or the coronary tree in Kawasaki disease. MRA may also be performed with intravenous (IV) contrast to assess the systemic arterial tree for evidence of extracardiac aneurysms in Kawasaki disease [36-38].