Investig Magn Reson Imaging.  2016 Jun;20(2):114-119. 10.13104/imri.2016.20.2.114.

Diagnosis of Right Ventricular Vegetation on Late Gadolinium-Enhanced MR Imaging in a Pediatric Patient after Repair of a Ventricular Septal Defect

Affiliations
  • 1Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yhchoe@skku.edu
  • 3HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Division of Cardiology, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

We report a case of vegetation in a 4-year-old female with infective endocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) imaging. The patient had a history of primary closure for ventricular septal defect and presented with mild febrile sensation. No remarkable clinical symptoms or laboratory findings were noted; however, transthoracic echocardiography demonstrated a 14 mm highly mobile homogeneous mass in the right ventricle. On LGE CMR imaging, the mass showed marginal rim enhancement, which suggested the diagnosis of vegetation rather than thrombus. The extracellular volume fraction (≥ 42%) of the lesion was higher than that of normal myocardium. Based on the patient's clinical history of congenital heart disease and pathologic confirmation of the lesion, a diagnosis of infective endocarditis with vegetation was made.

Keyword

Infective endocarditis; Vegetation; Late gadolinium enhancement; Cardiovascular magnetic resonance imaging; Right ventricle; Congenital heart disease

MeSH Terms

Child, Preschool
Diagnosis*
Echocardiography
Endocarditis
Female
Heart Defects, Congenital
Heart Septal Defects, Ventricular*
Heart Ventricles
Humans
Magnetic Resonance Imaging*
Myocardium
Sensation
Thrombosis
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