Correlation between cardiac and hepatic native T1 value and myocardial late gadolinium enhancement in children with Kawasaki disease.

Background: Kawasaki disease (KD) is an acute febrile illness and systemic vasculitis of unknown etiology that predominantly affects young children. The objective of this study was to investigate the correlation between myocardial and hepatic native T1 value and myocardial late gadolinium enhancement (LGE) in pediatric patients with KD.

Methods: In this cross-sectional retrospective study, 115 KD patients (50 in the acute phase, 65 in the chronic phase) and 40 age- and gender-matched controls underwent cardiac magnetic resonance (CMR) imaging with T1 mapping and LGE sequences. KD patients were subgrouped based on the myocardial LGE. Cardiac and hepatic T1 value as well as laboratory tests were also analyzed.

Results: Both cardiac and hepatic T1 value were significantly elevated in KD patients compared to controls, with the highest values noted in the acute phase (myocardial 1,393±70, 1,345±65, 1,303±62 ms; hepatic 813±25, 787±29, 758±38 ms; P=0.001, P=0.001, respectively). KD patients with myocardial LGE had significantly higher myocardial and hepatic T1 value in both the acute (1,442±66, 1,381±67 ms; 836±47, 803±30 ms, P=0.048, P=0.013, respectively) and chronic phases (myocardial 1,393±91, 1,331±50 ms; hepatic 811±39, 780±21 ms, P=0.012, P=0.001, respectively). Multivariate analysis demonstrated a significant correlation between the disease phase, albumin, and hepatic T1 value in KD patients. The combined of myocardial and hepatic T1 value significantly enhances the diagnostic performance of myocardial LGE, increasing the area under the curve (AUC) from 0.773 to 0.881 (P=0.013).

Conclusions: Elevated myocardial and hepatic T1 values correlate with myocardial LGE in KD, highlighting systemic involvement. The integration of these T1 values enhances the non-invasive diagnosis of myocardial involvement in KD, demonstrating their utility in assessing disease severity and progression.