Learning objectives
Cardiac magnetic resonance (CMR) could represent a useful technique for evaluation of cardiac function,
myocardial morphology and assessment of acute and chronic damages in patients with endocarditis of Loeffler.
Background
Hypereosinophilic syndrome (HES) is a rare condition that could be associated with multiorgan dysfunction.
Heart involvement is evident in 75% of patients and it is characterized by fibrous thickening of endocardium,
mural thrombosis,
apical obliteration and in long term progressive heart failure caused by restrictive cardiomyopathy.
It is very difficult and much rarer observe the long-term effects of previous endocarditis.
Diffuse endomyocardial calcifications could be observed in dead or degenerative tissue (“dystrophic”calcification).
In long term cardiac involvement of HES is associated to endomyocardial fibrosis and...
Findings and procedure details
10-15 minutes after the intravenous administration of contrast agent using sequences contrast enhancement inversion recovery is possible the visualization of endocardial damage (fibrosis with or without calcification) and the presence of stratified mural thrombus.
Steady state free precession sequences (SSFP) in short axis,
four and two chambers provide informations on systolic function,
myocardial thickness and about segmental and global kinetics.
SSFP sequences are useful for visualization of hypokinetic myocardial wall involved by endocarditis,
septal dyskinesia and establishing differential diagnosis between apical hypertrophic cardiomyopathy and thickening...
Conclusion
CMR provides useful information for the assessment of the severity of heart involvement in HES and for accurate management of patient.
Personal information
Dr.
Giuseppe Muscogiuri
Radiology resident:
(1)Department of Radiological Sciences
University of Rome -"Sapienza"- Sant'Andrea Hospital
Via di Grottarossa,
1035.
00189 Rome,
Italy
(2)Department of Imaging
Bambino Gesù - Children's Hospital IRCCS
Piazza Sant’Onofrio,
4.
00165 Rome,
Italy
[email protected]
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Cardiacinvolvement...