Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay
| Autor: | Jean-Paul Casalta, Franck Thuny, Guy Moulin, Didier Raoult, Alexis Jacquier, Jean-Yves Gaubert, Gilbert Habib, Antonin Flavian, A. Grob, Chloe Villacampa |
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| Rok vydání: | 2014 |
| Předmět: |
Thorax
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Interventional radiology Pictorial Review Valvular damage medicine.disease Pseudoaneurysm Multidetector Valve replacement Echocardiography Infective endocarditis medicine cardiovascular system Radiology Nuclear Medicine and imaging Radiology cardiovascular diseases Abscess business Computed tomography Septic embolism Neuroradiology |
| Zdroj: | Insights into Imaging |
| ISSN: | 1869-4101 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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