title: The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results.
abstract: OBJECTIVE
  We aimed to evaluate the utility of cardiac magnetic resonance imaging (MRI) for the diagnosis of infective endocarditis (IE).
  
  
  METHODS
  Sixteen patients with a preliminary diagnosis of IE (10 women and six men; age range, 4-66 years) were referred for cardiac MRI. MRI sequences were as follows: echo-planar cine true fast imaging with steady-state precession (true-FISP), dark-blood fast spin echo T1-weighted imaging, T2-weighted imaging, dark-blood half-Fourier single shot turbo spin echo (HASTE), and early contrast-enhanced first-pass fast low-angle shot (FLASH). Delayed contrast-enhanced images were obtained using three-dimensional inversion recovery FLASH after 15±5 min. The MRI features were evaluated, including valvular pathologies on cine MRI and contrast enhancement on the walls of the cardiac chambers, major thoracic vasculature, and paravalvular tissue, attributable to endothelial extension of inflammation on contrast-enhanced images.
  
  
  RESULTS
  Fourteen valvular vegetations were detected in eleven patients on cardiac MRI. It was not possible to depict valvular vegetations in five patients. Vegetations were detected on the aortic valve (n=7), mitral valve (n=3), tricuspid and pulmonary valves (n=1). Delayed contrast enhancement attributable to extension of inflammation was observed on the aortic wall and aortic root (n=11), paravalvular tissue (n=4), mitral valve (n=2), walls of the cardiac chambers (n=6), interventricular septum (n=3), and wall of the pulmonary artery and superior mesenteric artery (n=1).
  
  
  CONCLUSIONS
  Valvular vegetation features of IE can be detected by MRI. Moreover, in the absence of vegetations, detection of delayed enhancement representing endothelial inflammation of the cardiovascular structures can contribute to the diagnosis and treatment planning of IE.
authors.affiliation: Department of Radiology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey. yilmazerdem79@yahoo.com.tr.
authors.forename: Memduh
authors.initials: M
authors.lastname: Dursun
authors.forename: Sabri
authors.initials: S
authors.lastname: Yılmaz
authors.forename: Erdem
authors.initials: E
authors.lastname: Yılmaz
authors.forename: Ravza
authors.initials: R
authors.lastname: Yılmaz
authors.forename: İmran
authors.initials: İ
authors.lastname: Onur
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Aygün
authors.initials: A
authors.lastname: Dindar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult