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Related Experiment Videos

Perivalvular pseudoaneurysm complicating bacterial endocarditis: MR detection in five cases.

E W Akins1, R M Slone, B N Wiechmann

  • 1Department of Radiology, University of Florida College of Medicine, JHMHC, Gainesville 32610-0374.

AJR. American Journal of Roentgenology
|June 1, 1991
PubMed
Summary

Cardiac MR imaging effectively detects life-threatening perivalvular pseudoaneurysms in bacterial endocarditis patients. This advanced imaging offers crucial pre- and postoperative insights, surpassing traditional echocardiography in identifying these complications.

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Area of Science:

  • Cardiology
  • Radiology
  • Infectious Diseases

Background:

  • Bacterial endocarditis typically impacts heart valve leaflets.
  • Erosion can lead to myocardial abscesses and perivalvular abscesses.
  • These abscesses may rupture, forming pseudoaneurysms, a critical complication.

Purpose of the Study:

  • To evaluate the efficacy of cardiac Magnetic Resonance (MR) imaging in diagnosing perivalvular pseudoaneurysms secondary to bacterial endocarditis.
  • To compare the diagnostic performance of cardiac MR imaging with conventional echocardiography.

Main Methods:

  • Retrospective review of 14 patients with complicated bacterial endocarditis.
  • ECG-gated spin-echo cardiac MR imaging was performed.
  • Comparison with duplex two-dimensional echocardiography (2-D echo) and angiography where available.

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Main Results:

  • Cardiac MR imaging detected pseudoaneurysms in all 5 surgically confirmed cases.
  • 2-D echocardiography identified only 3 of these pseudoaneurysms.
  • Postoperative MR imaging identified recurrent pseudoaneurysms and thrombosed aneurysms.

Conclusions:

  • Cardiac MR imaging is a valuable tool for diagnosing perivalvular pseudoaneurysms in endocarditis.
  • It provides essential pre- and postoperative information, aiding clinical management.
  • MR imaging demonstrates superior sensitivity compared to 2-D echocardiography for these specific complications.