Dalebout Eefje M, Hirsch Alexander, Kluin Jolanda, Galema Tjebbe W, Roos-Hesselink Jolien W, Budde Ricardo P J
Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, the Netherlands.
Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.
J Soc Cardiovasc Angiogr Interv. 2024 Mar 26;3(3Part B):101292. doi: 10.1016/j.jscai.2023.101292. eCollection 2024 Mar.
Imaging is one of the cornerstones in diagnosis and management of infective endocarditis, underlined by recent guidelines. Echocardiography is the first-line imaging technique, however, computed tomography (CT) has a class I recommendation in native and prosthetic valve endocarditis to detect valvular lesions in case of possible endocarditis and to detect paravalvular and periprosthetic complications in case of inconclusive echocardiography. Echocardiography has a higher diagnostic accuracy than CT in detecting valvular lesions, but not for diagnosing paravalvular lesions where CT is superior. Additionally, CT is useful and recommended by guidelines to detect extracardiac manifestations of endocarditis and in planning surgical treatment including assessment of the coronary arteries. The advent of photon-counting CT and its improved spatial resolution and spectral imaging is expected to expand the role of CT in the diagnosis of infective endocarditis. In this review, we provide an overview of the current role of CT in infective endocarditis focusing on image acquisition, image reconstruction, interpretation, and diagnostic accuracy.
影像学是感染性心内膜炎诊断和管理的基石之一，近期指南强调了这一点。超声心动图是一线成像技术，然而，计算机断层扫描（CT）在天然瓣膜和人工瓣膜心内膜炎中具有I类推荐，用于在可能的心内膜炎情况下检测瓣膜病变，并在超声心动图结果不明确时检测瓣周和人工瓣膜周围并发症。超声心动图在检测瓣膜病变方面比CT具有更高的诊断准确性，但在诊断瓣周病变方面不如CT，CT在这方面更具优势。此外，CT对于检测心内膜炎的心外表现以及规划手术治疗（包括评估冠状动脉）很有用且得到指南推荐。光子计数CT的出现及其 improved spatial resolution and spectral imaging有望扩大CT在感染性心内膜炎诊断中的作用。在本综述中，我们概述了CT在感染性心内膜炎中的当前作用，重点关注图像采集、图像重建、解读和诊断准确性。 （注：原文中“improved spatial resolution and spectral imaging”表述不太准确，可能影响理解，推测可能是“提高的空间分辨率和光谱成像”之类意思，这里按原文翻译）
