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.

Fig. 5: Findings and Procedure Details
References: Department of Imaging Bambino Gesù - Children's Hospital IRCCS

Fig. 6: Loeffler endocarditis with subendocardial calcification (arrowhead) and mural thrombus (arrow)
References: Department of Imaging Bambino Gesù - Children's Hospital IRCCS

 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 of the apical myocardial segments due to Loeffler endocarditis; furthermore using dedicated software it is possible to obtain a good assessment of cardiac volumes and systolic function.

Fig. 4: Findings and Procedure Details
References: Department of Imaging Bambino Gesù - Children's Hospital IRCCS

 Evaluation with CMR of diastolic function in Loeffler endocarditis is allowed by phase contrast sequences applied in pulmonary vein, mitral and tricuspidal valves planes orthogonal to blood flow; these sequences give information about the examinated flow pattern and determine grading of diastolic dysfunction.

Fig. 3: Findings and Procedure Details.
References: Department of Imaging Bambino Gesù - Children's Hospital IRCCS