1. Magnetic Resonance Imaging Susceptibility-Weighted Imaging Lesion and Contrast Enhancement May Represent Infectious Intracranial Aneurysm in Infective Endocarditis
- Author
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Cory Rice, Dolora Wisco, Julian Hardman, Ken Uchino, Robert J. Marquardt, Infective Endocarditis Strokes, Jean Khoury, Sung Min Cho, Andrew B. Buletko, Lucy Zhang, and Prateek Thatikunta
- Subjects
Male ,medicine.medical_specialty ,Contrast enhancement ,Computed Tomography Angiography ,Contrast Media ,030204 cardiovascular system & hematology ,Infectious intracranial aneurysm ,Tertiary Care Centers ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Odds Ratio ,Humans ,Medicine ,Retrospective Studies ,Endocarditis ,medicine.diagnostic_test ,business.industry ,Angiography, Digital Subtraction ,Intracranial Aneurysm ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Cerebral Angiography ,Logistic Models ,Neurology ,Infective endocarditis ,Multivariate Analysis ,Susceptibility weighted imaging ,Female ,Neurology (clinical) ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Aneurysm, Infected ,Intracranial Hemorrhages ,030217 neurology & neurosurgery ,Cerebral angiography - Abstract
Background: Infectious intracranial aneurysm (IIA) can complicate infective endocarditis (IE). We aimed to describe the magnetic resonance imaging (MRI) characteristics of IIA. Methods: We reviewed IIAs among 116 consecutive patients with active IE by conducting a neurological evaluation at a single tertiary referral center from January 2015 to July 2016. MRIs and digital cerebral angiograms (DSA) were reviewed to identify MRI characteristics of IIAs. MRI susceptibility weighted imaging (SWI) was performed to collect data on cerebral microbleeds (CMBs) and sulcal SWI lesions. Results: Out of 116 persons, 74 (63.8%) underwent DSA. IIAs were identified in 13 (17.6% of DSA, 11.2% of entire cohort) and 10 patients with aneurysms underwent MRI with SWI sequence. Nine (90%) out of 10 persons with IIAs had CMB >5 mm or sulcal lesions in SWI (9 in sulci, 6 in parenchyma, and 5 in both). Five out of 8 persons who underwent MRI brain with contrast had enhancement within the SWI lesions. In a multivariate logistic regression analysis, both sulcal SWI lesions (p < 0.001, OR 69, 95% CI 7.8-610) and contrast enhancement (p = 0.007, OR 16.5, 95% CI 2.3-121) were found to be significant predictors of the presence of IIAs. Conclusions: In the individuals with IE who underwent DSA and MRI, we found that neuroimaging characteristics, such as sulcal SWI lesion with or without contrast enhancement, are associated with the presence of IIA
- Published
- 2017
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