Detection of Perivalvular Abscess with Late Gadolinium-Enhanced MR Imaging in a Patient with Infective Endocarditis
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초록
We report a case of perivalvular abscess in a 66-year-old man with infectiveendocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magneticresonance (CMR) imaging. No clinical features suspicious of infective endocarditiswere noted, however, transthoracic echocardiography revealed non-specific echogenicfocal wall thickening at mitral-aortic intervalvular fibrosa. Perivalvular abscess in theaortic valve was demonstrated as focal wall thickening between the anterior mitralleaflet and the non-coronary cusp of the aortic valve with peripheral enhancementand central low signal intensity on LGE CMR imaging. Other features suggestiveof infective endocarditis, such as neither vegetation nor valvular perforation werepresent. The perivalvular abscess did not grow after intensive intravenous antibioticstherapy, and the patient was discharged without surgical treatment. CMR withLGE provided an early accurate diagnosis of perivalvular abscess. The diagnosis ofperivalvular abscess using LGE CMR imaging was not previously reported in Korea.
Abstract
We report a case of perivalvular abscess in a 66-year-old man with infectiveendocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magneticresonance (CMR) imaging. No clinical features suspicious of infective endocarditiswere noted, however, transthoracic echocardiography revealed non-specific echogenicfocal wall thickening at mitral-aortic intervalvular fibrosa. Perivalvular abscess in theaortic valve was demonstrated as focal wall thickening between the anterior mitralleaflet and the non-coronary cusp of the aortic valve with peripheral enhancementand central low signal intensity on LGE CMR imaging. Other features suggestiveof infective endocarditis, such as neither vegetation nor valvular perforation werepresent. The perivalvular abscess did not grow after intensive intravenous antibioticstherapy, and the patient was discharged without surgical treatment. CMR withLGE provided an early accurate diagnosis of perivalvular abscess. The diagnosis ofperivalvular abscess using LGE CMR imaging was not previously reported in Korea.
참고문헌 (9)
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