MRI versus CT in the detection of brain lesions in patients with infective endocarditis before or after cardiac surgery

Abstract Purpose Imaging of brain involvement in infective endocarditis can drive the clinical management of this serious condition. MRI is very sensitive, but CT is more readily available. In this retrospective study, we compared the detection rates of CT and MRI. Methods After Ethics Committee approval, we retrospectively reviewed a series of 20 patients (13 males, median age 64 years) who underwent both CT and MRI either before or after cardiac surgery for definite infective endocarditis. Plain CT and MRI were evaluated for acute ischemic lesions, both punctuate and large, intraparenchymal hemorrhages, cerebral microbleeds, subarachnoid hemorrhages, abscesses, microabscesses, and meningitis. Qualitative assessment and McNemar test were performed. The value of contrast-enhanced scans (MRI, n = 14; CT, n = 9) and cognitive status were also assessed. Results A total of 166 lesions were identified on either technique: 137 (83%) on MRI only, 4 (2%) on CT only, and 25 (15%) on both techniques (p < 0.001). For these last 25 lesions, concordance on lesion type was only 16/25 (64%). MRI detected more microbleeds and ischemic lesions, while the 4 CT-only findings were false positives. Contrast-enhanced scans identified 68 enhancing lesions, mainly abscesses and microabscesses, and allowed a better characterization for 61/117 lesions (52%) with MRI, and for 11/81 (14%) with CT. Follow-up identified mild cognitive impairment in 6/13 and dementia in 3/13 patients. Conclusion While CT rapidly excludes large hemorrhages in patients with infective endocarditis, MRI accurately distinguishes the whole spectrum of brain lesions, including small ischemic lesions, microbleeds, and microabscesses.

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Role of CEUS in Vascular Pathology

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1403-2400 ◽

2021 ◽

Author(s):

Vito Cantisani ◽

Nicola Di Leo ◽

Emanuele David ◽

Dirk-André Clevert

Keyword(s):

Research Field ◽

Arterial System ◽

Qualitative Assessment ◽

Vascular Pathology ◽

New Horizons ◽

Contrast Enhanced ◽

Inflammatory Infiltrates ◽

Time Evaluation

AbstractIn recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.

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P66 DAPTOMYCIN USE IN INFECTIVE ENDOCARDITIS AT A CARDIAC SURGERY REFERRAL HOSPITAL, 20092012, RIO DE JANEIRO, BRAZIL

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(13)70090-6 ◽

2013 ◽

Vol 41 ◽

pp. S26

Author(s):

A. Parente ◽

M. Lima ◽

C.A. Januarioda Silvad ◽

R. Fernandes ◽

C. Lamas

Keyword(s):

Cardiac Surgery ◽

Infective Endocarditis ◽

Rio De Janeiro ◽

Referral Hospital

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Incidence and Predictors of Postoperative Need for High-Dose Inotropic Support in Patients Undergoing Cardiac Surgery for Infective Endocarditis

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2017.12.015 ◽

2018 ◽

Vol 32 (6) ◽

pp. 2528-2536 ◽

Cited By ~ 4

Author(s):

Alessandro Belletti ◽

Stephan Jacobs ◽

Giovanni Affronti ◽

Alexander Mladenow ◽

Giovanni Landoni ◽

...

Keyword(s):

Cardiac Surgery ◽

Infective Endocarditis ◽

Inotropic Support ◽

High Dose

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Degree of Enhancement on Contrast Enhanced Spectral Mammography (CESM) and Lesion Type on Mammography (MG): Comparison Based on Histological Results

Medical Science Monitor ◽

10.12659/msm.900371 ◽

2016 ◽

Vol 22 ◽

pp. 3886-3893 ◽

Cited By ~ 17

Author(s):

Elżbieta Łuczyńska ◽

Joanna Niemiec ◽

Edward Hendrick ◽

Sylwia Heinze ◽

Janusz Jaszczyński ◽

...

Keyword(s):

Contrast Enhanced ◽

Lesion Type ◽

Histological Results

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Comparison of F18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Dynamic Contrast-Enhanced Magnetic Resonance Imaging as Markers of Graft Viability in Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546518805092 ◽

2018 ◽

Vol 47 (1) ◽

pp. 88-95 ◽

Cited By ~ 2

Author(s):

Siva Srivastava Garika ◽

Anshul Sharma ◽

Abdul Razik ◽

Akshima Sharma ◽

Ravindra Mohan Pandey ◽

...

Keyword(s):

Fdg Pet ◽

Cruciate Ligament ◽

Acl Graft ◽

Positron Emission ◽

Contrast Enhanced ◽

Pet Ct ◽

Anterior Cruciate ◽

Fdg Pet Ct ◽

Ct And Mri

Background: F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) can be used to assess changes in the metabolism of an anterior cruciate ligament (ACL) graft as it is undergoing “ligamentization.” Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the preferred modality for noninvasive assessment of graft structure and graft vascularity. Purpose: To compare the use of F18-FDG PET/CT and DCE-MRI to assess ligamentization within the ACL graft and correlate the results with clinical tests. Study Design: Case series; Level of evidence, 4. Methods: Among 30 recruited patients, 27 patients (3 females and 24 males) completed 2 follow-up assessments at a mean of 125 ± 22 days and 259 ± 38 days after arthroscopic ACL reconstruction. At both assessments, anterior drawer test, Lachman test, and Lysholm scoring (LS) were conducted. Images from F18-FDG PET/CT and MRI were analyzed qualitatively and quantitatively (maximum standardized uptake value [SUVmax], SUVmax ratio to the contralateral side [SUVmax CL], normalized enhancement [NE]) in 3 zones: femoral, intra-articular (IA), and tibial. Of the 27 recruited patients, 1 patient had reinjury due to a fall. Therefore, 26 patients were considered for the final analysis. Results: A significant improvement ( P = .0001) was found in median LS, from 78.5 (range, 62-90) to 94.5 (range, 84-100), at the second follow-up. All grafts were found to be viable on PET/CT and vascularized on MRI. All grafts were seen as continuous on MRI, with exception of 1 graft at the second follow-up. Dynamic MRI identified single-vessel supply to all of the grafts at the first follow-up and multiple-vessel supply in 10 patients at the second follow-up. Reduction in the median SUVmax, SUVmax CL, and NE at second follow-up was seen in all 3 zones. Only SUVmax CL in the IA zone showed a significant reduction ( P = .032); patients with excellent LS at the second follow-up showed significantly higher reduction ( P = .005) than patients with good LS. NE in the IA zone was correlated (0.39; P = .048) with LS only at the first follow-up, whereas SUVmax CL (–0.52; P = .006) and SUVmax (–0.49, P = .010) in the IA zone negatively correlated with LS at the second follow-up only. No correlation was observed between PET/CT and MRI parameters. Conclusion: Glucose metabolism and vascularity in the graft tissue can be used to assess ligamentization of ACL graft. A viable and vascularized graft at first follow-up is associated with good to excellent final outcome, regardless of LS at this stage. Since no correlation was observed between PET/CT and MRI parameters, they may be assessing different domains of the same process. Higher NE in the IA zone at the first follow-up and lower SUVmax CL in the same region at second follow-up are associated with better outcome.

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A Case of Schwannoma of the Submandibular Region

The Open Dentistry Journal ◽

10.2174/1874210601812010012 ◽

2018 ◽

Vol 12 (1) ◽

pp. 12-18 ◽

Cited By ~ 1

Author(s):

Babatunde O. Bamgbose ◽

Akiko Sato ◽

Yoshinobu Yanagi ◽

Miki Hisatomi ◽

Yohei Takeshita ◽

...

Keyword(s):

Diagnostic Imaging ◽

Hypoglossal Nerve ◽

Salivary Gland Tumor ◽

Dynamic Mri ◽

Final Diagnosis ◽

Mr Images ◽

Submandibular Region ◽

Contrast Enhanced ◽

Mobile Mass ◽

Ct And Mri

Background:We herein described a rare case of schwannoma of the hypoglossal nerve in the submandibular region with diagnostic imaging and histopathological findings.Case Report:A 31-years-old woman has had a palpable firm, rubbery, freely mobile mass in the submandibular region. Of imaging, MR images showed homogeneous isointensity on T1-weighted imaging (T1-WI), heterogeneous hypointensity on T2-WI, heterogeneous hyperintensity on short T1 inversion recovery (STIR), and heterogeneous enhancement on contrast-enhanced T1-WI. A clear capsule was observed on the margin and showed hypointense on T2-WI. Dynamic MRI showed heterogeneous gradual increased enhancement. The uptake of contrast medium was regionally slow. Diagnostic imaging using CT and MRI was suspected of salivary gland tumor or neurogenic tumor. In consideration of imaging diagnosis, a pleomorphic adenoma or a schwannoma was suspected. Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings.Conclusion:1. Histopathologic examination is inevitable, because MR findings are not specific.2. Schwannomas were said to have specific MRI properties, including specific signs (split-fat sign, fascicular sign, target sign). However, they are not always observed.3. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.

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Pulmonary Embolism Originating from a Hepatic Hydatid Cyst Ruptured into the Inferior Vena Cava: CT and MRI Findings

Case Reports in Radiology ◽

10.1155/2016/3589812 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Necdet Poyraz ◽

Soner Demirbaş ◽

Celalettin Korkmaz ◽

Kürşat Uzun

Keyword(s):

Pulmonary Embolism ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Liver Cyst ◽

Mri Findings ◽

Contrast Enhanced ◽

Magnetic Resonance Imaging Mri ◽

Enhanced Computed Tomography ◽

Ct And Mri

Pulmonary embolism due to hydatid cysts is a very rare clinical entity. Hydatid pulmonary embolism can be distinguished from other causes of pulmonary embolism with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). MRI especially displays the cystic nature of lesions better than CECT. Here we report a 45-year-old male patient with the pulmonary embolism due to ruptured hydatid liver cyst into the inferior vena cava.

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