Endocarditis MRI: Difference between revisions

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==Overview==
==Overview==
Findings on cardiac MRI suggestive of infective endocarditis include valvular vegetations, valvular and perivalvular damage, and vascular endothelial involvement.<ref name="pmid25430531">{{cite journal| author=Dursun M, Yılmaz S, Yılmaz E, Yılmaz R, Onur İ, Oflaz H et al.| title=The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results. | journal=Diagn Interv Radiol | year= 2015 | volume= 21 | issue= 1 | pages= 28-33 | pmid=25430531 | doi=10.5152/dir.2014.14239 | pmc=PMC4463365 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430531  }} </ref>
Findings on cardiac [[Magnetic resonance imaging|MRI]] suggestive of infective [[endocarditis]] include [[Valvular heart disease|valvular]] [[Vegetation (pathology)|vegetations]], valvular and perivalvular damage, and vascular [[endothelial]] involvement.


==MRI==
==MRI==
Findings on cardiac MRI suggestive of infective endocarditis include valvular vegetations, valvular and perivalvular damage, and vascular endothelial involvement.<ref name="pmid25430531">{{cite journal| author=Dursun M, Yılmaz S, Yılmaz E, Yılmaz R, Onur İ, Oflaz H et al.| title=The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results. | journal=Diagn Interv Radiol | year= 2015 | volume= 21 | issue= 1 | pages= 28-33 | pmid=25430531 | doi=10.5152/dir.2014.14239 | pmc=PMC4463365 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430531  }} </ref>
Findings on cardiac [[Magnetic resonance imaging|MRI]] suggestive of infective [[endocarditis]] include:<ref name="pmid25430531">{{cite journal| author=Dursun M, Yılmaz S, Yılmaz E, Yılmaz R, Onur İ, Oflaz H et al.| title=The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results. | journal=Diagn Interv Radiol | year= 2015 | volume= 21 | issue= 1 | pages= 28-33 | pmid=25430531 | doi=10.5152/dir.2014.14239 | pmc=PMC4463365 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430531  }} </ref>
*[[Valvular]] [[Vegetation (pathology)|vegetations]]
*Enhancement of the [[Vegetation (pathology)|vegetations]] and [[abscess]] both is an indication of cardiac endothelial inflammation
*[[Valvular]] and perivalvular damage
*[[Vascular]] [[Endothelium|endothelial]] involvement
*Can detect small ischemic lesions in the brain that can lead to neurologic complications
*MRI helps in quantification of regurgitation fraction
*[[Magnetic resonance imaging|MRI]] also helpful in decision-making which involves in:<ref name="pmid23615478">{{cite journal| author=Goulenok T, Klein I, Mazighi M, Messika-Zeitoun D, Alexandra JF, Mourvillier B | display-authors=etal| title=Infective endocarditis with symptomatic cerebral complications: contribution of cerebral magnetic resonance imaging. | journal=Cerebrovasc Dis | year= 2013 | volume= 35 | issue= 4 | pages= 327-36 | pmid=23615478 | doi=10.1159/000348317 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23615478  }}</ref>
**Cardiac [[surgery]] indication
**Timing of [[valve]] replacement


==ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance<ref name="pmid20479157">{{cite journal| author=American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA et al.| title=ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. | journal=Circulation | year= 2010 | volume= 121 | issue= 22 | pages= 2462-508 | pmid=20479157 | doi=10.1161/CIR.0b013e3181d44a8f | pmc=PMC3034132 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20479157  }} </ref> (DO NOT EDIT)==
[[File:Intraparenchymal hemorrhage.gif|center|thumb|748x748px|MRI of the brain demonstrating punctate areas of intraparenchymal hemorrhage. Case courtesy by Patricia Almeida<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972922/|title=A Rare Case of Streptococcus alactolyticus Infective Endocarditis Complicated by Septic Emboli and Mycotic Left Middle Cerebral Artery Aneurysm|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
{{cquote|
 
CMR may be used for assessing individuals with valvular heart disease in which evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or prosthetic valve disease are needed. CMR may be useful in identifying serial changes in LV volumes or mass in patients with valvular dysfunction.
 
}}
[[File:Vegetations on the aortic valve.jpg|center|thumb|723x723px|Exemplary long axis views of the mouse heart acquired with self-gated CINE UTE MRI (TR/TE : 5/0.31 ms, FA: 15°, resol: (125 µm)2, MTX: 256×256, slice thickness: 1 mm, scan duration: 12∶08 min) show the aortic valves in closed (A–C) and open (D–F) state. Flow artifacts were almost completely suppressed by the use of self-gated UTE MRI. (A,D) Images of a mouse with sham surgery infected with unlabeled bacteria show normal valves (arrows). (B, E) In images of a catheterized mouse infected with unlabeled bacteria the catheter as well as valve thickening and an additional intracardiac mass is visible (arrows). (C, F) Large hyperintensities on the valves (arrows) are observed in this catheterized mouse infected with iron labeled bacteria. Case courtesy Janine Ring et al<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167704/|title=MRI Visualization of Staphylococcus aureus-Induced Infective Endocarditis|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
<br />
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Infectious disease]]
 
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]

Latest revision as of 01:33, 6 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]

Overview

Findings on cardiac MRI suggestive of infective endocarditis include valvular vegetations, valvular and perivalvular damage, and vascular endothelial involvement.

MRI

Findings on cardiac MRI suggestive of infective endocarditis include:[1]

  • Valvular vegetations
  • Enhancement of the vegetations and abscess both is an indication of cardiac endothelial inflammation
  • Valvular and perivalvular damage
  • Vascular endothelial involvement
  • Can detect small ischemic lesions in the brain that can lead to neurologic complications
  • MRI helps in quantification of regurgitation fraction
  • MRI also helpful in decision-making which involves in:[2]
MRI of the brain demonstrating punctate areas of intraparenchymal hemorrhage. Case courtesy by Patricia Almeida[3]


Exemplary long axis views of the mouse heart acquired with self-gated CINE UTE MRI (TR/TE : 5/0.31 ms, FA: 15°, resol: (125 µm)2, MTX: 256×256, slice thickness: 1 mm, scan duration: 12∶08 min) show the aortic valves in closed (A–C) and open (D–F) state. Flow artifacts were almost completely suppressed by the use of self-gated UTE MRI. (A,D) Images of a mouse with sham surgery infected with unlabeled bacteria show normal valves (arrows). (B, E) In images of a catheterized mouse infected with unlabeled bacteria the catheter as well as valve thickening and an additional intracardiac mass is visible (arrows). (C, F) Large hyperintensities on the valves (arrows) are observed in this catheterized mouse infected with iron labeled bacteria. Case courtesy Janine Ring et al[4]


References

  1. Dursun M, Yılmaz S, Yılmaz E, Yılmaz R, Onur İ, Oflaz H; et al. (2015). "The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results". Diagn Interv Radiol. 21 (1): 28–33. doi:10.5152/dir.2014.14239. PMC 4463365. PMID 25430531.
  2. Goulenok T, Klein I, Mazighi M, Messika-Zeitoun D, Alexandra JF, Mourvillier B; et al. (2013). "Infective endocarditis with symptomatic cerebral complications: contribution of cerebral magnetic resonance imaging". Cerebrovasc Dis. 35 (4): 327–36. doi:10.1159/000348317. PMID 23615478.
  3. "A Rare Case of Streptococcus alactolyticus Infective Endocarditis Complicated by Septic Emboli and Mycotic Left Middle Cerebral Artery Aneurysm".
  4. "MRI Visualization of Staphylococcus aureus-Induced Infective Endocarditis".

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