Natsumi Katsumata MD, Presenter: Nothing to Disclose

Jun Aoki MD, Abstract Co-Author: Nothing to Disclose

Keigo Endo MD, Abstract Co-Author: Nothing to Disclose

To find out characteristics of cervical CT findings helpful for early diagnosis of Kawasaki disease (mucocutaneous lymph node syndrome), in which delayed diagnosis and inappropriate treatment may result in fatal coronary artery aneurysm.

Approval for this retrospective study was not required by the institutional review board. We retrospectively reviewed cervical CT images of 49 children which had been performed in our hospital between January 2006 and August 2008. The patients were from 8 months to 15 years in age, and all had cervical lymphadenopathy with unknown causes at the first medical examination. The distribution of enlarged lymph nodes (>1.5cm in maximum diameter) and other findings in cervical soft tissues were evaluated. The statistical significance was analyzed based on the Mann-Whiteny U-test.

Eighteen patients were finally diagnosed as Kawasaki disease by the classic clinical criteria of the disease, and other 31 patients were diagnosed as non-Kawasaki diseases which included lymphadenopathy with unknown cause in 11 patients, parapharyngeal abscess in 11, suppurative lymphadenopathy in 3, otitis media in 2, and EB virus infection, infectious mononucleosis, Sjogren syndrome, and pyriform sinus fistula in each one. Jugrodigastric lymph node enlargement was found in all Kawasaki diseases and in 94% (29/31) of non-Kawasaki disease. Retropharyngeal lymph node enlargement was observed in 78% (14/18) of Kawasaki disease and in 26% (8/31) of non-Kawasaki disease (P0.5). Submandibular lymph node enlargement was noted in 1 Kawasaki disease and in 3 non-Kawasaki disease. Supraclaviculra lymph node enlargement was detected in none of Kawasaki disease and in 1 non-Kawasaki disease. Retropharyngeal edema was observed in 72% (13/18) of Kawasaki diseases and in 32% (10/31) of non-Kawasaki disease (P<0.017).

Retropharyngeal lymphadenopathy and edema were significantly frequent in Kawasaki disease, and therefore these CT findings may be helpful for suggesting the diagnosis in an early phase of the disease.

Retropharyngeal lymphadenopathy and edema were significantly frequent in Kawasaki disease, and therefore these CT findings may be helpful for suggesting the diagnosis in an early phase of the disease.

Katsumata, N, Aoki, J, Endo, K, Characteristics of Cervical CT Findings of Kawasaki Disease.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007985.html