Investigative Magnetic Resonance Imaging  2016;20(2):114-119

doi: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.

Jewon JEONG 1 ; Hae Jin KIM ; Sung Mok KIM ; June HUH ; Ji Hyuk YANG ; Yeon Hyeon CHOE

Affiliations

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Keywords

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

Country

Republic of Korea

Language

English

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.