Background: Coronary artery imaging in the pediatrics, is usually performed for the evaluation of coronary origin and course or for coronary aneurysms.
Available modalities in the pediatric population include: echocardiography,catheterization, CTA and MRI . Echocardiography might be limited , while both catheterization and CCTA are related to non-negligible exposure to ionizing radiation and the administration of iodinated IV contrast.
Cardiac MRI allows coronary artery scan without the penalty of radiation exposure or IV contrast administration.
Methods: A retrospective analysis (October 2010 November 2013).
The study included 35 patients. Clinical indications included coronary artery origin and course demonstration (N=29) and follow up post Kawaski disease for coronary aneurysms. 29 patients were suspected for coronary anomalous origin six patients with post Kawaski disease. Study cohort characteristics: average age 6 years, mean weight: 26 Kg .
Cardiac sequences included: 3D SSFP , double inversion recovery (when images were not sufficient). In all cases no IV contrast was administered. Scan length: average 15 minutes.
Results:. The study included 35 scans. Normal coronary course and origin was demonstrated in 25 patients (25/29). 2 patients (2/29) were found with anomalous origin coronary one with left coronary from the right coronary sinus and the second with anomalous origin of the circumflex from the right coronary sinus. Diagnostic quality was achieved in 32/35 scans, 2/35 scans was unsatisfied .
Coronary aneurysms were documented in 4 patients referred for follow up post Kawasaki disease (4/4).
Conclusion: CMR allows diagnostic information for evaluation of the coronary arteries ,specifically in the pediatric population. CMR allows demonstration of coronary artery course and origin as well as the presence of coronary aneurysms.
CMR should be considered as the modality of choice for coronary evaluation in the pediatric population, especially in the light of no exposure to ionizing radiation or IV contrast administration.
