Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA.
J Cardiovasc Comput Tomogr. 2012 Nov-Dec;6(6):399-405. doi: 10.1016/j.jcct.2012.10.001. Epub 2012 Oct 12.
Infective endocarditis (IE) is a disease characterized by high rates of morbidity and mortality that can present with a spectrum of clinical and imaging findings. Cardiac-gated computed tomographic angiography (CTA) has been shown to be highly accurate in evaluation of both coronary artery disease and structural heart disease and is now considered an appropriate preoperative imaging modality in patients undergoing noncoronary cardiac surgery. This review discusses the use of cardiac-gated CTA in preoperative evaluation of patients with IE, with emphasis on imaging findings of valvular and perivalvular complications. Topics include technique tips specific to valve imaging with cardiac-gated CTA, potential benefits of cardiac-gated CTA compared with other imaging modalities such as echocardiography, limitations of imaging patients with IE with cardiac-gated CTA, and an overview of potential findings in patients with IE, including vegetations, valve perforations, perivalvular abscesses, perivalvular pseudoaneurysms, and fistulas. Throughout this review, cardiac-gated CTA findings of IE are presented with echocardiographic and operative correlation to emphasize that cardiac-gated CTA may in select cases provide incremental benefit in the preoperative assessment of patients with IE.
感染性心内膜炎（IE）是一种发病率和死亡率都很高的疾病，其临床表现和影像学表现多种多样。心脏门控 CT 血管造影（CTA）已被证明在评估冠状动脉疾病和结构性心脏病方面具有高度准确性，目前被认为是接受非冠状动脉心脏手术的患者的合适术前影像学检查方法。本综述讨论了心脏门控 CTA 在 IE 患者术前评估中的应用，重点介绍了瓣膜和瓣周并发症的影像学表现。讨论的主题包括心脏门控 CTA 用于瓣膜成像的技术要点、与超声心动图等其他影像学方法相比心脏门控 CTA 的潜在优势、心脏门控 CTA 成像 IE 患者的局限性，以及 IE 患者的潜在影像学表现概述，包括赘生物、瓣膜穿孔、瓣周脓肿、瓣周假性动脉瘤和瘘管。在本综述中，IE 的心脏门控 CTA 表现与超声心动图和手术结果相关联，以强调在某些情况下，心脏门控 CTA 可能会为 IE 患者的术前评估提供额外的益处。
