小児患者におけるプリパレーションを用いた無鎮静でのMagnetic Resonance Coronary Angiographyの有用性

DOI
  • 渡邉 拓史
    日本大学医学部　小児科学系小児科学分野
  • 泉 裕之
    日本大学医学部　小児科学系小児科学分野 板橋区医師会病院　小児科
  • 浅野 賢一
    板橋区医師会病院　放射線科
  • 渡邊 直樹
    板橋区医師会病院　小児科
  • 神山 浩
    日本大学医学部　IR・医学教育センター
  • 鮎澤 衛
    日本大学医学部　小児科学系小児科学分野
  • 高橋 昌里
    日本大学医学部　小児科学系小児科学分野

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  • Utility of Magnetic Resonance Coronary Angiography without sedative medicine in the pediatric patient using preparation

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<p>Background: Magnetic resonance coronary angiography (MRCA) is a minimally invasive and radiation-free technique that enables evaluation of the coronary arteries in patients being followed-up for Kawasaki disease (KD). However, during MRCA scanning it is mandatory that patients lie still in bed for a long time. This is a major obstacle to the application of MRCA in pediatric patients.</p><p>Aims: We aimed to determine the utility of MRCA without using sedatives in pediatric patients using preparation.</p><p>Methods: Our study included 7 consecutive pediatric KD patients who underwent an MRCA to evaluate coronary artery lesions between 2010 and 2016 at the Itabashi Medical Association Hospital. The preparation for MRCA was performed in all patients, including a field trip and detailed explanation. The MRCA was conducted without sedatives. We compared the findings of MRCA and ultrasound cardiography (UCG) and investigated their correlation.</p><p>Results: The mean age of patients was 8.3 ± 4.1 years (range 4–15 years, 6 boys and 1 girl). The mean time from disease onset to the MRCA procedure was 2.7 ± 2.8 years. Scanning could be successfully completed in all patients without sedatives because pediatricians had prepared themselves adequately prior to scanning. The measurements of coronary artery in MRCA were significantly larger than those of UCG and showed a strong positive correlation.</p><p>Conclusion: An MRCA procedure can be performed without sedatives in pediatric KD patients, including children as young as 4 years (the youngest patient we experienced). Adequate preparations by physicians prior to scanning can reduce avoidable and unnecessary sedation in these patients.</p>

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