Bernard Iung1,2, François Rouzet3,4,5, Eric Brochet6, Xavier Duval7,8. 1. Cardiology Department, Bichat Hospital, AP-HP, DHU FIRE, 46 rue Henri Huchard, 75018, Paris, France. bernard.iung@bch.aphp.fr. 2. Paris-Diderot University, Paris, France. bernard.iung@bch.aphp.fr. 3. Paris-Diderot University, Paris, France. 4. Department of Nuclear Medicine, Bichat Hospital, AP-HP and DHU FIRE, Paris, France. 5. Inserm Unité Mixte de Recherche U1148, LVTS, Paris, France. 6. Cardiology Department, Bichat Hospital, AP-HP, DHU FIRE, 46 rue Henri Huchard, 75018, Paris, France. 7. Center of Clinical Investigations, Inserm 1425, Bichat Hospital, AP-HP, Paris, France. 8. Paris-Diderot University, Inserm U1137, Paris, France.
Abstract
PURPOSE OF REVIEW: The visualization of cardiac lesions is a major component of the diagnosis of infective endocarditis (IE). We review the usefulness of different cardiac imaging techniques for the diagnosis and management of IE. RECENT FINDINGS: Transthoracic echocardiography is indicated in all cases of suspected IE. Transesophageal echocardiography is used in most patients due to its higher sensitivity. When diagnosis remains doubtful, in particular for IE on foreign material, multislice computed tomography and nuclear medicine techniques, i.e., positron emission tomography and radiolabelled leucocyte scintigraphy, enable a higher proportion of IE to be classified as definite or rejected at an early stage. Imaging also plays a role in prognostic stratification and follow-up. Nuclear medicine and radiological imaging techniques are useful to diagnose cardiac lesions on IE when echocardiography is not conclusive. They should be used in selected patients and their findings should be integrated in a multidisciplinary management in endocarditis teams.
PURPOSE OF REVIEW: The visualization of cardiac lesions is a major component of the diagnosis of infective endocarditis (IE). We review the usefulness of different cardiac imaging techniques for the diagnosis and management of IE. RECENT FINDINGS: Transthoracic echocardiography is indicated in all cases of suspected IE. Transesophageal echocardiography is used in most patients due to its higher sensitivity. When diagnosis remains doubtful, in particular for IE on foreign material, multislice computed tomography and nuclear medicine techniques, i.e., positron emission tomography and radiolabelled leucocyte scintigraphy, enable a higher proportion of IE to be classified as definite or rejected at an early stage. Imaging also plays a role in prognostic stratification and follow-up. Nuclear medicine and radiological imaging techniques are useful to diagnose cardiac lesions on IE when echocardiography is not conclusive. They should be used in selected patients and their findings should be integrated in a multidisciplinary management in endocarditis teams.
Entities:
Keywords:
Computed tomography; Echocardiography; Endocarditis; Nuclear Imaging; Valvular surgery
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