Imaging the itis: endocarditis, myocarditis, and pericarditis

Inflammatory and/or infectious conditions affecting the heart and pericardium in children are primarily diagnosed via noninvasive imaging modalities. In addition, the use of multiple imaging modalities (multimodality imaging) is becoming increasingly common to assist in diagnosis, management, and prognosis. This review focuses on the use of noninvasive imaging in endocarditis, myocarditis, and pericarditis, with emphasis placed on the use of echocardiography and cardiac MRI in these conditions.

Echocardiography remains the most commonly employed imaging modality for all of the above diagnoses. However, echocardiography has several important limitations, foremost of which is a limited ability to characterize myocardial tissue abnormalities, such as inflammation and fibrosis. Quantitative assessment of cardiac output and valve function is also limited with echocardiography. Cardiac MRI is superior to echocardiography in these domains and provides useful complementary information.

Echocardiography and cardiac MRI play crucial roles in the diagnosis, management, and forecasting of prognosis in inflammatory and/or infectious conditions affecting the heart in children. New advances, particularly in MRI imaging, have allowed clinicians to provide more accurate diagnoses and information regarding prognosis.