Yang Ying Chi, Aung Thein Tun, Khan Sarah, Wase Abdul
1 University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
2 North East Ohio Medical University, Rootstown, OH, USA.
J Investig Med High Impact Case Rep. 2019 Jan-Dec;7:2324709618822075. doi: 10.1177/2324709618822075.
Infective endocarditis (IE) can lead to significant morbidity and mortality without appropriate treatment. Modified Duke Criteria are accepted by many professional societies to establish the diagnosis of IE, and cardiac imaging is one of the major diagnostic criteria. Transesophageal echocardiography is an algorithmic escalation to diagnose IE when transthoracic echo does not appreciate a positive finding. In patients with contraindications to transesophageal echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography (CT), cardiac CT angiography, and fluorodeoxyglucose positron emission tomography with CT or CT angiography may be alternative diagnostic tools. However, these imaging modalities have their own limitations such as local unavailability, the presence of non-magnetic resonance imaging compatible implants, or impaired renal function. Intracardiac echocardiography could be a considerable alternative under those circumstances.
感染性心内膜炎(IE)若未得到恰当治疗,可导致严重的发病和死亡。许多专业学会认可改良的杜克标准用于确立IE的诊断,而心脏成像检查是主要诊断标准之一。经胸超声心动图检查未发现阳性结果时,经食管超声心动图检查是诊断IE的一种逐步升级的检查方法。对于有经食管超声心动图检查禁忌证的患者,心脏磁共振成像、心脏计算机断层扫描(CT)、心脏CT血管造影以及氟脱氧葡萄糖正电子发射断层扫描联合CT或CT血管造影检查可能是可供选择的诊断工具。然而,这些成像检查方法都有其自身的局限性,如当地无法开展、存在与磁共振成像不兼容的植入物或肾功能受损等。在这些情况下,心腔内超声心动图检查可能是一个相当不错的替代选择。