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Multimodality Imaging of Infective Endocarditis.

Jordi Broncano1, Prabhakar Shanta Rajiah1, Daniel Vargas1

  • 1From the Department of Radiology, Cardiothoracic Imaging Unit, Hospital San Juan de Dios, HT Médica, Avenida el Brillante n° 36, 14012, Córdoba, Spain (J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.S.R., E.W.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Hospital Universitario Gregorio Marañón, Madrid, Spain (M.L.S.A.); Department of Radiology, McGovern Medical School, UT Health Houston, Houston, Tex (D.O.T.); Section of Cardiothoracic Imaging, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Mo (S.B.); Department of Cardiology, Hospital de la Cruz Roja-Grupo Corpal, Córdoba, Spain (J.C.F.C.); Department of Radiology, Section of MRI, Clínica las Nieves, Jaén, Spain (A.L.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|February 8, 2024
PubMed
Summary

Infective endocarditis (IE) diagnosis is improved by advanced cardiac CT and nuclear imaging, reclassifying up to 90% of possible IE cases as definite. These techniques aid in evaluating valvular and perivalvular involvement, crucial for patient management.

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Area of Science:

  • Radiology
  • Cardiology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a serious condition with high morbidity and mortality.
  • Current diagnostic criteria for IE have limitations in clinical practice.
  • Radiologists must maintain a high index of suspicion for IE.

Purpose of the Study:

  • To evaluate the role of advanced imaging in diagnosing infective endocarditis.
  • To assess the impact of cardiac CT and nuclear imaging on IE classification.
  • To highlight the utility of imaging in differentiating IE from other cardiac conditions.

Main Methods:

  • Review of imaging findings in infective endocarditis.
  • Comparison of modified Duke criteria with advanced imaging results.
  • Analysis of cardiac CT and nuclear imaging in diagnosing valvular and perivalvular IE.

Main Results:

  • Advanced imaging techniques, including cardiac CT and nuclear imaging, significantly increase the accuracy of IE diagnosis.
  • Up to 90% of possible IE cases can be reclassified as definite IE with advanced imaging.
  • Cardiac CT is particularly useful for high clinical suspicion, perivalvular involvement, and pre-operative planning.
  • Nuclear imaging plays a complementary role, especially in prosthetic valve endocarditis.

Conclusions:

  • Advanced cardiac imaging is essential for accurate and timely diagnosis of infective endocarditis.
  • Cardiac CT and nuclear imaging improve upon traditional diagnostic criteria, aiding in patient management and treatment planning.
  • Understanding imaging characteristics is key to differentiating IE from other cardiac pathologies.