Non-bacterial thrombotic endocarditis other imaging findings

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non-bacterial thrombotic endocarditis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

Whole-body CT or MRI may be helpful in the diagnosis of non-bacterial thrombotic endocarditis. It may show evidence of systemic embolism in patients with undetermined NBTE.

Other imaging findings

  • Whole-body CT or MRI may be helpful in the diagnosis of non-bacterial thrombotic endocarditis. It may show evidence of systemic embolism in patients with undetermined NBTE[1].
  • CT or MRI of the brain may be performed in NBTE patients with suspected cerebral embolization[2]. There is no pathognomonic finding but evidence of ischemia/embolism may be seen[3].
  • There is limited data to support the use of positron emission tomography (PET) in the diagnosis of NBTE[4].
  • So far only one published case report supports the use of cardiac magnetic resonance (CMR) in the diagnosis of NBTE[5].
MRI of the brain. Images on the top show increased signal on diffusion weighted imaging (DWI) throughout the bilateral frontal, parietal, and occipital lobes. Images on the bottom show a corresponding decreased signal intensity on apparent diffusion coefficient that is consistent with acute abnormal restricted diffusion. These findings suggest new/ongoing acute infarcts.Source: Ghulam Murtaza. et al, Department of Internal Medicine, Advocate Christ Medical Center, Oak Lawn, IL, USA
CT of head without contrast showing extensive multifocal areas of hypoattentuation throughout the bilateral frontal, parietal, occipital, and right > left temporal lobes. No mass effect or midline shift or hemorrhage was seen.Source: Ghulam Murtaza. et al, Department of Internal Medicine, Advocate Christ Medical Center, Oak Lawn, IL, USA

References

  1. "Nonbacterial Thrombotic Endocarditis: Pathogenesis, Diagnosi... : Cardiology in Review".
  2. Borowski A, Ghodsizad A, Cohnen M, Gams E (June 2005). "Recurrent embolism in the course of marantic endocarditis". Ann. Thorac. Surg. 79 (6): 2145–7. doi:10.1016/j.athoracsur.2003.12.024. PMID 15919332.
  3. Singhal AB, Topcuoglu MA, Buonanno FS (May 2002). "Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study". Stroke. 33 (5): 1267–73. doi:10.1161/01.str.0000015029.91577.36. PMID 11988602.
  4. "Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Infective Endocarditis - ScienceDirect".
  5. Elagha A, Mohsen A (April 2019). "Cardiac MRI clinches diagnosis of Libman-Sacks endocarditis". Lancet. 393 (10182): e39. doi:10.1016/S0140-6736(19)30770-6. PMID 31034381.