目的　探讨320排动态容积CT冠状动脉成像(CTA)及经胸超声心动图(TTE)对川崎病(KD)合并冠状动脉瘤(CAA)中远期随访的应用价值。方法　采用320排CTA、TTE进行中远期追踪随访8例KD合并CAA患儿。结果　8例患儿平均发病年龄(41.63±22.70)月，随访时间(43.50±10.99)月。急性期TTE诊断冠状动脉巨大瘤(GCAA)3例，中小瘤5例，共累及冠状动脉16/32支(50.0%)。随访观察终点时TTE示GCAA 3例及中小瘤2例仍存在，另3例小瘤消退，仍累及冠状动脉6/32支(18.6%)。随访观察终点时320排CTA检查示累及冠状动脉7/32支(21.9%)，分布部位与TTE基本一致；另发现左回旋支扩张1例，右冠状动脉(RCA)远段GCAA 1处、血栓2处、狭窄1处、钙化2处。结论　KD引起的CAA可长期存在，GCAA后期可发生冠状动脉血栓、狭窄或钙化。TTE观察近中段冠脉改变敏感可靠，但对于中远段冠脉损害的观察有局限性。320排CTA能较全面地观察各支冠状动脉的病变，尤其对急性期后冠状动脉血栓，钙化及近、远端狭窄的观察敏感可靠。

Objective　To assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD). Methods　320-detector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD. Results　In 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21.9%) were involved by 320-detector row CTA. The distribution was consistent with that of TTE. Meanwhile, there were one case of left circumflex artery, one case of GCAA at distal of the right coronary artery, 2 cases of thrombus, 1 case of coronary stenosis and 2 cases of calcification. Conclusions　CAA caused by KD may be persistent for a long time. The thrombus, stenosis, and calcification of coronary can occurr at late phase in GCAA. TTE is sensitive and reliable to detect proximal and middle segment of coronary lesions, but has limitations in detection of distal segment of coronary arteries. 320-detector row CTA has more comprehensively view of each coronary artery lesions and is especially sensitive and reliable to detect coronary thrombosis, calcification and narrowing in proximal and distal coronary arteries after acute phase.