MRI versus CT in the detection of brain lesions in patients with infective endocarditis before or after cardiac surgery.
Abscess
Computed tomography
Endocarditis
Magnetic resonance imaging
Subarachnoid hemorrhage
Journal
Neuroradiology
ISSN: 1432-1920
Titre abrégé: Neuroradiology
Pays: Germany
ID NLM: 1302751
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
13
07
2021
accepted:
10
09
2021
pubmed:
15
10
2021
medline:
15
4
2022
entrez:
14
10
2021
Statut:
ppublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 34647143
doi: 10.1007/s00234-021-02810-y
pii: 10.1007/s00234-021-02810-y
pmc: PMC9005423
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
905-913Subventions
Organisme : ministero della salute
ID : Ricerca Corrente
Informations de copyright
© 2021. The Author(s).
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