Evidence map›Paper›PMID 41247478›Full record

ArticleEuropean radiology2026

Quantitative evaluation of myocardial fibrosis in pediatric patients with Kawasaki disease and coronary artery aneurysms by MRI-derived extracellular volume fraction.

Zhiming Yang, Yanan Chen, Quanli Shen, Yan Zheng, Guanke Cai, Chenxi Hu, Junpu Hu, Kai Lu, Yuanzheng Zheng, Ai Shang and 3 more

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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13 authors.

Zhiming Yang *Department of Radiology, Children's Hospital, Fudan University, Shanghai, China.
Yanan Chen *Department of Radiology, Shanghai Pulmonary Hospital, Shanghai, China.
Quanli ShenDepartment of Radiology, Children's Hospital, Fudan University, Shanghai, China.
Yan ZhengDepartment of Radiology, Children's Hospital, Fudan University, Shanghai, China.
Guanke CaiDepartment of Radiology, Children's Hospital, Fudan University, Shanghai, China.
Chenxi HuSchool of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China.
Junpu HuUnited Imaging Research, United Imaging Healthcare, Shanghai, China.
Kai LuUnited Imaging Research, United Imaging Healthcare, Shanghai, China.
Yuanzheng ZhengHeart Centre, Children's Hospital, Fudan University, Shanghai, China.
Ai ShangDepartment of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Fei ShanDepartment of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. shanfei@shaphc.org.
Qiong YaoDepartment of Radiology, Children's Hospital, Fudan University, Shanghai, China. yaoqiong_x_ray@163.com.ORCID http://orcid.org/0000-0002-1021-3208
Xihong HuDepartment of Radiology, Children's Hospital, Fudan University, Shanghai, China. huxihong@fudan.edu.cn.

Funding

National Natural Science Foundation of China 82400580
6 · The paper itself

Abstract

objectivesTo quantify myocardial fibrosis in Kawasaki disease (KD) patients with coronary artery aneurysms (CAAs) by MRI-derived extracellular volume fraction (ECV). MATERIALS AND

methodsThis prospective study included KD with CAAs and healthy volunteers with cardiac MRI. The image analyses included CAA size and thrombus, late gadolinium enhancement (LGE), global and regional (basal, middle, apex) ECV values. ECV values of the control and KD subgroups were compared, and the independent predictive factors of ECV were explored.

resultsThe analysis included 49 patients with large CAAs (mean age, 5.87 ± 2.18 [SD]; 40 (81.6%) males), 40 patients with medium (n = 20) and small (n = 20) CAAs (mean age, 5.34 ± 1.96 [SD]; 33 (82.5%) males), and 20 healthy volunteers (mean age, 6.22 ± 1.77 [SD]; 15 (75.0%) males). Patients with large CAAs are more prone to thrombosis than those with medium and small CAAs (p = 0.033). The global ECV value in patients with large CAAs, medium and small CAAs, and controls has a significant difference (34.37% ± 3.33 vs 33.64% ± 3.27 vs 32.23% ± 2.68, p = 0.032, p = 0.038, p = 0.006, respectively). The regional ECV value showed the same trend. There were significant differences between patients with and without coronary thrombosis and LGE (all p < 0.050). Multivariate analysis revealed that coronary artery thrombosis and LGE were independently correlated with the global ECV.

conclusionKD patients with CAAs have diffuse myocardial fibrosis, and the degree of myocardial fibrosis is more severe in patients with large CAAs and coronary thrombosis and LGE. KEY POINTS: Question Highlights the unmet need for non-invasive fibrosis quantification in KD, as prior methods (e.g., LGE) lack sensitivity for diffuse fibrosis. Findings ECV elevation (size-dependent) in CAAs, along with thrombosis and LGE, serves as an independent predictor of ECV. Clinical relevance Emphasizes ECV's role in risk stratification and guiding therapy (e.g., thromboprophylaxis), directly linking to patient outcomes.

Indexed as

Coronary AneurysmMagnetic Resonance ImagingMucocutaneous Lymph Node SyndromeMyocardiumChildChild, PreschoolContrast MediaFemaleFibrosisHumansMaleProspective StudiesContrast MediaCoronary aneurysmExtracellular spaceKawasaki diseaseMagnetic resonance imaging (cine)Myocardial ischemia

Identifiers

PMID41247478

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