Clinical value of MRI,blood culture,and transthoracic echocardiography in diagnosis of infective endocarditis

国际医药卫生导报 Pub Date : 2019-12-01 DOI:10.3760/CMA.J.ISSN.1007-1245.2019.23.025

Z. Zhijie, Wang Jianmei, Wang Danping

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Abstract

Objective To explore the clinical value of MRI, blood culture, and transthoracic cardiac ultrasound in the diagnosis of infective endocarditis (IE). Methods 134 IE patients admitted to our hospital from January, 2016 to June, 2018 were retrospectively selected as the study objects. All the patients had the data of MRI, blood culture, and transthoracic ultrasound diagnosis as well as of prognosis. The detection rates of vegetations of different sizes and different locations by MRI and the chest cardiac ultrasound were observed. The pathogenic bacteria distribution characteristics of blood culture were analyzed. The diagnostic accuracies of the three methods were compared. Results The detection rate of transthoracic echocardiography was 93.28%, and was significantly higher than that of MRI (72.39%; P<0.05). The detection rate of transthoracic echocardiography for vegetation less than 5 mm was 27.61%, and was significantly higher than that of MRI (11.94%; P<0.05). The detection rates of aortic and pulmonary valve vegetations by transthoracic echocardiography were 14.93% and 11.94%, respectively, which were significantly higher than those of MRI (5.97% and 2.99%; both P<0.05). In blood culture examination, the detection rate of pathogens was 61.19%; Gram-positive bacteria were the main pathogens, accounting for 53.66%. The combined diagnostic accuracy of the three methods was 98.51%, which was significantly higher than those of transthoracic echocardiography, MRI, and blood culture (93.28%, 72.39%, and 61.19%; all P<0.05). Conclusion The application of MRI and blood culture combined with transthoracic electrocardiogram for IE patients has improved the detection rate of vegetation sites and provided more information on cardiac function and pathogenic microorganisms, and helped clinicians to develop more effective interventions. Key words: Infective endocarditis; MRI; Blood culture; Transthoracic cardiac ultrasound

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MRI、血培养和经胸超声心动图对感染性心内膜炎的诊断价值

目的探讨MRI、血液培养和经胸超声对感染性心内膜炎（IE）的诊断价值。方法回顾性选择我院2016年1月至2018年6月收治的134例IE患者作为研究对象。所有患者均有MRI、血培养、经胸超声诊断及预后资料。观察不同大小、不同位置的植物在MRI和胸部心脏超声检查中的检出率。分析了血液培养的病原菌分布特点。比较了三种方法的诊断准确性。结果经胸超声心动图的检出率为93.28%，明显高于MRI的检出率（72.39%；P＜0.05），经胸超声心动图对主动脉瓣和肺动脉瓣赘生物的检出率分别为14.93%和11.94%，均显著高于MRI（5.97%和2.99%，均P<0.05）；三种方法联合诊断的准确率为98.51%，明显高于经胸超声心动图、MRI、，结论MRI和血培养结合经胸心电图对IE患者的应用提高了植被部位的检出率，提供了更多关于心功能和病原微生物的信息，有助于临床医生制定更有效的干预措施。关键词：感染性心内膜炎；MRI；血液培养；经胸心脏超声

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国际医药卫生导报

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