Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay.
Insights Imaging
; 5(5): 559-70, 2014 Oct.
Article
em En
| MEDLINE
| ID: mdl-25225108
ABSTRACT
OBJECTIVES:
The goals of this pictorial essay are (1) to set out a multislice computed tomography (MSCT) imaging protocol to assess infective endocarditis (IE); (2) to give an MSCT overview of valvular and peri-valvular involvement during IE; (3) to give a CT overview of septic embolism and infectious pseudoaneurysms during IE.METHODS:
MSCT acquisition protocols to assess IE are performed in two different phases the first acquisition, under electrocardiography (ECG) gating, covers the cardiac structures during first-pass iodine injection; the second acquisition covers the thorax, abdomen, pelvic and cerebral regions.RESULTS:
Valvular and peri-valvular lesions during IE are vegetation-a hypodense, homogeneous, irregular mass on a valve or endocardial structure; perforation-a defect in the leaflet; valvular aneurysm-loss of the homogenous curvature of the leaflet; valvular thickening; peri-valvular abscess; pseudoaneurysm; fistula and disinsertion of a prosthetic valve. Extra-cardiac location could involve all organs.CONCLUSIONS:
MSCT can be considered as a useful complement in visualising the cardiac lesions of IE if echocardiography is inconclusive. MSCT is the only imaging modality that provides assessment of valvular and peri-valvular involvement, extra-cardiac lesions, and non-invasive evaluation of the coronary artery anatomy, simultaneously. MAIN MESSAGES ⢠MSCT provides assessment of coronary anatomy, cardiac and extra-cardiac lesions. ⢠MSCT represents an alternative to echocardiography during IE. ⢠Surgical valve replacement is usually required if vegetation is >10 mm. ⢠Peri-valvular extension (abscesses, pseudoaneurysm and fistulae) required surgical treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article