Studies have also demonstrated cardiac CT to have comparable accuracy to TEE for identification of vegetations in the setting of infective endocarditis, another potential source of arterial embolism [36-38]. Cardiac CT can identify cardiac neoplasms, both benign and malignant, which have the potential to shed and embolize to distal arterial beds [39,40]. CTA Chest With IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta, and a CTA limited to the chest may be diagnostic. As such, multidetector chest CTA with IV contrast can be used to evaluate for at-risk atherosclerotic plaque or the presence of thrombus in the thoracic aorta. CTA is useful in the assessment of the size, extent, and location of an embolic source in the aorta, which can aid in management decisions [13,41]. A number of small studies have used chest CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. CTA Chest, Abdomen, and Pelvis With IV contrast Multidetector CTA with IV contrast can be used to evaluate for the presence of at-risk atherosclerotic plaque or thrombus in the aorta in its entirety. CTA is useful in the assessment of the size, extent, and location of an embolic source in the aorta, which can aid in management decisions [13,41]. Aortic intraluminal thrombus is oftentimes associated with aneurysm, particularly in the abdomen, which is readily detected by CTA [56,57]. A number of small studies have used CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. MRA Chest Without and With IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta and an MRA limited to the chest may be diagnostic.
Workup of Noncerebral Systemic Arterial Embolic Source. Studies have also demonstrated cardiac CT to have comparable accuracy to TEE for identification of vegetations in the setting of infective endocarditis, another potential source of arterial embolism [36-38]. Cardiac CT can identify cardiac neoplasms, both benign and malignant, which have the potential to shed and embolize to distal arterial beds [39,40]. CTA Chest With IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta, and a CTA limited to the chest may be diagnostic. As such, multidetector chest CTA with IV contrast can be used to evaluate for at-risk atherosclerotic plaque or the presence of thrombus in the thoracic aorta. CTA is useful in the assessment of the size, extent, and location of an embolic source in the aorta, which can aid in management decisions [13,41]. A number of small studies have used chest CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. CTA Chest, Abdomen, and Pelvis With IV contrast Multidetector CTA with IV contrast can be used to evaluate for the presence of at-risk atherosclerotic plaque or thrombus in the aorta in its entirety. CTA is useful in the assessment of the size, extent, and location of an embolic source in the aorta, which can aid in management decisions [13,41]. Aortic intraluminal thrombus is oftentimes associated with aneurysm, particularly in the abdomen, which is readily detected by CTA [56,57]. A number of small studies have used CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. MRA Chest Without and With IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta and an MRA limited to the chest may be diagnostic.