Greer M E, Ghuman N, Johnson P T, Zimmerman S L, Fishman E K, Facciola J, Azadi Javad R
School of Medicine, Georgetown University, Washington, DC, USA.
Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed 4030, Baltimore, MD, USA.
Emerg Radiol. 2024 Oct;31(5):759-765. doi: 10.1007/s10140-024-02257-7. Epub 2024 Jun 28.
Infective endocarditis (IE) is a disease with high morbidity and mortality rate, but diagnosis is confounded by diverse clinical presentations, which mimic other pathologies. A history of illicit intravenous drug use, previous cardiac valve surgery, and indwelling intracardiac devices increases the risk for developing infective endocarditis. The modified Duke criteria serve as the standard diagnostic tool, though its accuracy is reduced in certain cases. Radiologists in the Emergency Room setting reading body CT may be the first to identify the secondary extra-cardiac complications and facilitate expeditious management by considering otherwise unsuspected infective endocarditis. This review highlights common extracardiac complications of IE and their corresponding CT findings in the chest, abdomen, pelvis, and brain. If IE is suspected radiologists should suggest further investigation with echocardiography.
感染性心内膜炎（IE）是一种发病率和死亡率都很高的疾病，但由于其临床表现多样，易与其他病症混淆，导致诊断困难。有非法静脉注射毒品史、既往心脏瓣膜手术史以及心内留置装置会增加发生感染性心内膜炎的风险。改良的杜克标准是标准的诊断工具，不过在某些情况下其准确性会降低。在急诊室阅读身体CT的放射科医生可能是最先识别继发性心外并发症的，并通过考虑原本未被怀疑的感染性心内膜炎来促进快速治疗。本综述重点介绍了感染性心内膜炎常见的心外并发症及其在胸部、腹部、骨盆和脑部相应的CT表现。如果怀疑有感染性心内膜炎，放射科医生应建议进一步进行超声心动图检查。
