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Is brain angio-MRI useful in infective endocarditis management?
J Champey1, P Pavese2, H Bouvaist3
1Intensive Care Medicine, CHU de Grenoble, BP 218, 38043, Grenoble Cedex 9, France. JChampey@chu-grenoble.fr.
Summary
Systematic early brain MRI in infective endocarditis (IE) did not significantly alter diagnosis or treatment. Further research is needed to determine optimal timing and patient selection for brain imaging in IE management.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Infective endocarditis (IE) poses a risk for silent neurological events.
- Brain magnetic resonance imaging (MRI) can detect these events.
Purpose of the Study:
- To assess the utility of early, systematic brain MRI in diagnosing IE.
- To evaluate its impact on the medico-surgical management of IE patients.
Main Methods:
- A prospective study involving 37 IE patients underwent brain MRI within 7 days of suspicion.
- Expert panels reviewed cases with and without MRI results to determine diagnosis and treatment.
- Paired comparisons were analyzed using a symmetry test.
Main Results:
- Brain MRI was abnormal in 70% of patients, revealing microischemia (62%) and microbleeds (58%).
- Diagnosis and expert recommendations showed no significant difference between groups with and without MRI data.
- Treatment strategies diverged in 13.5% and diagnoses in 5.4% of cases.
Conclusions:
- Systematic early brain MRI does not significantly impact IE diagnosis or treatment plans.
- The routine use of early brain MRI in IE appears irrelevant.
- Further studies are required to define the role, optimal timing, and patient selection for MRI in IE management.
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