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《》《》。DOI10．3969/j．issn．1003－515X．2011．21．002200127ImagingDiagnosisofCoronaryArteryLesioninKawasakiDiseaseCHENShu－baoDepartmentofCardiologyShanghaiChildren'sMedicalCenterAffiliatedtoShanghaiJiaotongUniversityMedicalCollegeShanghai200127China。20%～30%IVIG5%。。、。。、。、。CT。CT。CT。。201126211619－1623R729A1003－515X201121－1619－055。/。/1。-。、、、、、、。。1CD8+T、。。/。IgA。。。。。。1-2。、＜5mm5～8mm＞8mm。30%～50%10d6～8。20%。20%～30%IVIG5%2-4。IVIG12．9%1．96%0．27%5。LADLCX。2a40%～60%10%10%1%40%～60%4。。1%～3%6。1．90～19．2311．40。22．1。。1977。·9161·2621201111JApplClinPediatrVol．26No．21Nov．2011。、。5～7．5MHz。。。LAD、RCA、LMCA、LCX、RCARCA2。、。。1．5。。。、、。。1984＜5＞3mm≥5＞4mm1．52。＜32．5mm3～9＜3．0mm＞9＜3．5mm7。。。。1998deZorzi81252．989。10d、2、61a1+2s15．3%、21．4%、12．2%11．8%。27%。deZorzi8LMCA、LADRCA1Z。2004deZorzi8+2．5s。≥+2．5s0．6%2。2002Kurotobi971432～32．2a62。1+2s30%。0．5m2LAD3mm6s。。Kurotobi91。2003Tan103902～8。LCARCA、、1Z。AoALCA/AoA=0．15±0．020．09～0．21RCA/AoA=0．13±0．020．09～0．20。、、、。LCA/AoA＞0．19RCA/AoA＞0．17。Oliveri114320～20LM-CA、RCALADZZ=cm－β1－β2×BSAm2槡/MSE。LMCAm2LMCAβ1β2MSELM-CAZZ。Oliveri11±2sMcCrindle12Tan10±2s。1LMCAsLADsRCAsdeZorzi81．688+0．995BSA0．4201．186+0．820BSA0．3561．503+0．499BSA0．378Kurotobi91．339BSA+1．2191．276BSA+0．8631．187BSA+0．871Tan100．981+1．527BSA0．2030．742+1．431BSA0．2000．925+1．585BSA0．1740．696+1．415BSA0．173。。、Z。。Mc-Crindcle12Oliveri11。、。Z。+2s。1．5。。1·0261·2621201111JApplClinPediatrVol．26No．21Nov．2011。。Hiraishi132DE7．5MHz98%99%。Kato32DE99%95%。2DE。Presti2DELAD98%67%。Hiraishi132DE85%98%80%97%。。Hamaoka14812MHz。。14。、、。。。Michio15LAD2DE。2DE。LAD。。。。。2、6～8。4～81a。8。0．5～1．0a。2．230MHz3．5F。。Sugimura16。Lemura1710a272250．59mm0．29mm。2．3MRA10aMRA。MRA、、。MRA。MRA。Greil18MRA。610～252n=11、n=2、n=20．4±0．6mm1．4±1．6mm0．2±0．5mm0．1±1．5mm。MRALMCALAD42±17mmRCA91±35mmLCX27±9mm。Suzuki19SSFPMRA10697、47、18、1710。2828．9%。MRA13。1。MRA97．2%97．2%94．2%99．5%。。MRA＜2mm。2．4CTCTMDCT、、MRA。MDCT。MDCT。Chu20MDCT1667～15LMCA10．0±5．1mmLAD124．0±26．0mmLCX·1261·2621201111JApplClinPediatrVol．26No．21Nov．201153．0±33．8mmRCA144．0±43．8mm。127532。MDCT。Arnold21165～27MDCT16、MRA14。MDCTMRA100%93%90%50%。MDCT4MRA1。MDCT0．3～0．6mm。16CT0．625mm。MDCT。。Peng2264MDCT121．8～7．8。75．6%118/156307．5±3．8mm12．4±9．1mm536。12。MDCT。1h70·min－1。＞75·min－1。16MDCT15s。CT。CT。ECGMDCT15～18mSv6mSv。ECG＞80%1．5～3．0mSv23。。。MDCT。64128CT。2．5、、、。。。、。Takahashi、Judkins。。、2。。1．70%0．05%0．07%0．26%23。2。。1BurnsJCGlodeMP．KawasakidiseaseJ．Lancet2004364533－544．2NewburgerJWTakahashiMGerberMAetal．Diagnosistreatmentandlong－termmanagementofkawasakidiseaseAstatementforhealthpro-fessionalsfromthecommitteeonrheumaticfeverendocarditisandka-wasakidiseasecounciloncardiovasculardiseaseintheyoungamericanheartassociationJ．Pediatrics200411461708－1733．3KatoH．CardiovascularcomplicationsinkawasakidiseaseCoronaryar-terylumenandlong－termconsequencesJ．ProgPediatrCardiol2004192137－145．4SenzakiH．Long－termoutcomeofkawasakidiseaseJ．Circulation2008118252763－2772．5JapaneseCirculationSocietyJointReseachGroup．Guidelinesfordiagno-sisandmanagementofcardiovascularseuelaeinKawasakidiseaseJ．PediatrInt2005476711－732．6TsudaEKamiyaTOnoYetal．DilatedcoronaryarteriallesionsinthelateperiodafterkawasakidiseaseJ．Heart2005912177－182．7．M．6．1996687．8deZorziAColanSDGauvreauKetal．CoronaryarterydimensionsmaybemisclassifiedasnormalinKawasakidiseaseJ．JPediatr19981332254－258．9KurotobiSNagaiTKawakamiNetal．Coronarydiameterinnormalin-fantschildrenandpatientswithkawasakidiseaseJ．PediatrInt20024411－4．10TanTHWongKYChengTKetal．Coronarynormogramsandtheco-ronary－aortaindexObjectivedeterminantsofcoronaryarterydilata-tionJ．PediatrCardiol2003244328－335．11OlivieriLArlingBFribergMetal．CoronaryarteryZscorevregres-sionequationsandcalculatorsderivedfromalargeheterogeneouspopu-lationofchildrenundergoingechocardiographyJ．JAmSocEchocar-diogr2009222159－164．12McCrindleBWLiJSMinichLLetal．CoronaryarteryinvolvementinchildrenwithkawasakidiseaseRiskfactorsfromanalysisofserialnor-malizedmeasurementsJ．Circulation20071162174－179．13HiraishiSMisawaHTakedaNetal．Transthoracicultrasonicvisuali-sationofcoronaryaneurysmstenosisandocclusioninkawasakidiseaseJ．Heart2000834400－405．14HamaokaANiboshiAOzawaSetal．Linearshadowsinsidecoronaryarteriallesionsontwo－dimensionalechocardiograhpyinkawasakidi-seasepatientsJ．JCardiol2009533349－354．15MichioMKarasawaKKazuoTetal．Usefulnessofreal－time3－di-mensionalechocardiographyfortheevaluationofcoronaryarterymor-phologyinpatientswithkawasakidiseaseJ．JAmSocEchocardiogr2007208930－933．16SugimuraTKatoHInoueOetal．Intravascularultrasoundofcoronaryarteriesinchildren．AssessmentofthewallmorphologyandthelimenafterKawasakidiseaseJ．Circulation1994891258－265．17LemuraMIshiiMSugimuraTetal．Longtermconsequencesofre-gressedcoronaryaneurysnsofkawasakidiseaseJ．Heart2000833307－311．18GreilGFStuberMBotnarRMetal．Coronarymagneticresonancean-giographyinadolescentsandyoungadultswithkawasakidiseaseJ．Circulation20021058908－911．19SuzukiATakemuraAInabaRetal．Magneticresonancecoronaryan-giographytoevaluatecoronaryarteriallesionsinpatientswithkawasakidiseaseJ．CardiolYoung2006166563－571．·2261·2621201111JApplClinPediatrVol．26No．21Nov．201120ChuWCMokGCLamWWetal．Assessmentofcoronaryarteryan