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Case Reports
. 2019 Feb 25;14(5):544-547.
doi: 10.1016/j.radcr.2019.02.006. eCollection 2019 May.

Diagnosis of infective endocarditis with cardiac CT in an adult

Kotaro Ouchi  1 , Toshiro Ebihara  2 , Masaki Niitani  2 , Masato Makino  2 , Makoto Hirose  2 , Daisuke Iiduka  2 , Kazuo Misumi  2
Affiliations
Case Reports

Diagnosis of infective endocarditis with cardiac CT in an adult

Kotaro Ouchi et al. Radiol Case Rep. .

Abstract

The diagnosis of infective endocarditis is based on modified Duke's criteria, which includes clinical, biological, and echocardiographic findings. However, computed tomography (CT) has not been mentioned as a diagnostic tool in the criteria. We report a case of infective endocarditis confirmed by cardiac CT in which we could identify vegetations and perivalvular abscess not on transthoracic echocardiography and transesophageal echocardiography. Cardiac CT was feasible imaging modality for evaluating and diagnosing infective endocarditis. Cardiac CT should be recommended in patients with clinical suspicion of infective endocarditis even when transthoracic echocardiography and transesophageal echocardiography is negative for infective endocarditis.

Keywords: Cardiac computed tomography; Infective endocarditis.

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Figures

Fig. 1
Fig. 1
Transesophageal echocardiography midesophageal aortic valve short axis view (A) and Midesophageal aortic valve long axis view (B) on the fifth day showed heavy calcifications in aortic valve. The vegetations could not be identified.
Fig. 2
Fig. 2
Cardiac CT (iCT, Philips, the Netherlands) was performed in double phase scan with the initial arterial phase and second delayed phase scan on the 12th day. Scan parameters were: slice collimation, 128 × 0.625 mm; gantry rotation time, 270 milliseconds (SDFlash) or 330 milliseconds (SD); pitch, 0.2; tube voltage, 120 kVp and tube current, 400 mAs. Cardiac CT axial (A, C) and sagittal (B) image showed vegetations in aortic valve (arrow (A), (B)), and perivalvular abscess which involved in the region of atrioventricular node (arrow (C)).
See this image and copyright information in PMC

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