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Congress: ECR25
Poster Number: C-19853
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-19853
Authorblock: I. Sánchez Serna, A. F. Jiménez Sánchez, M. Sánchez Martínez, J. J. Molina Najas, A. G. Jiménez, J. I. Tudela Martínez, L. Contreras Espejo; Murcia/ES
Disclosures:
Irene Sánchez Serna: Nothing to disclose
Andrés Francisco Jiménez Sánchez: Nothing to disclose
Marcos Sánchez Martínez: Nothing to disclose
José Juan Molina Najas: Nothing to disclose
Alvaro García Jiménez: Nothing to disclose
Jose Ignacio Tudela Martínez: Nothing to disclose
Lucía Contreras Espejo: Nothing to disclose
Keywords: Cardiac, CT-Angiography, CT-High Resolution, Image manipulation / Reconstruction, Contrast agent-intravenous, Abscess, Aneurysms, Infection
Learning objectives This educational review highlights the essential role of cardiac computed tomography (CT) in diagnosing infective endocarditis (IE), emphasizing its ability to detect valvular vegetations, perivalvular complications, and extracardiac manifestations. It also demonstrates excellent correlation with surgical findings. This review explores advanced imaging techniques, including optimized protocols, contrast dynamics, and artifact reduction strategies to enhance diagnostic accuracy.Beyond diagnosis, cardiac CT aids surgical and therapeutic decision-making by offering detailed anatomical visualization. Early identification of complications such as pseudoaneurysms, fistulas, and systemic embolization...
Read more Background This is a retrospective review of patients diagnosed with infective endocarditis based on the modified Duke criteria. Data from transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and ECG-gated retrospective cardiac CT were analyzed. Patients from a tertiary care hospital, where cardiac CT is essential for diagnosing infective endocarditis, were included.Urgent cases had same-day CT access, while PET imaging, though available, was less frequently used. For cardiac evaluation, a 256-detector CT scanner with 16 cm detector coverage and 0.23 mm slice thickness...
Read more Findings and procedure details Echocardiography remains the primary imaging modality for diagnosing infective endocarditis (IE). However, in cases of poor TTE quality or high clinical suspicion, TEE is recommended. Despite its utility, TEE has limitations due to artifacts from prosthetic valves and difficulty in assessing extracardiac complications.Cardiac CT overcomes these challenges, demonstrating high sensitivity (96%) and specificity (97%) for detecting valvular and perivalvular lesions, particularly in the aortic position [1,2,3]. It is especially valuable in prosthetic valve endocarditis (PVE), where artifacts limit TEE accuracy....
Read more Conclusion Cardiac CT has become indispensable in diagnosing and managing IE, offering detailed anatomical visualization and detecting critical complications such as vegetations, pseudoaneurysms, fistulas, valve dehiscence, and systemic emboli. While considerations such as artifacts, radiation exposure, and accessibility remain, integrating CT findings with MRI and PET/CT enhances clinical decision-making. Multidisciplinary collaboration is crucial for optimizing patient management and treatment planning.
Read more References Grob A, Thuny F, Villacampa C, et al. Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay. Insights Imaging 2014;5(5):559-570. Feuchtner GM, Stolzmann P, Dichtl W, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol 2009;53(5):436-444. Sakuma H. Multimodality imaging for more accurate diagnosis and risk assessment in infective endocarditis. Radiology2020;297(2):342-343. https://doi.org/10.1148/radiol.2020203115. Broncano J, Rajiah PS, Vargas D, et al. Multimodality imaging of infective endocarditis. Radiographics2024;44(3):e230031. doi: 10.1148/rg.230031. Dalebout EM, Hirsch A, Kluin...
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