Endocarditis MRI

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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:

• 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:
  • Cardiac surgery indication
  • Timing of valve replacement

MRI of the brain demonstrating punctate areas of intraparenchymal hemorrhage. Case courtesy by Patricia Almeida

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