In depicting aortic valve pseudoaneurysms, one study showed a sensitivity, specificity, PPV, and NPV of 100%, 87.5%, 91.7%, and 100%, respectively [18]. Compared with echocardiography, CT may be superior in both detecting and visualizing the full extent of a paravalvular Infective Endocarditis abscess, pseudoaneurysm, or fistula, particularly in patients with prosthetic valves [7,10,20-23]. CT may be equivalent or superior to echocardiography in identifying vegetations and valve dehiscence in suspected prosthetic valve endocarditis [7,22,24]. CT may also be utilized to assess for abnormalities in the mobility of mechanical heart valves and to identify causes of mechanical valve dysfunction that are missed on echocardiography and fluoroscopy [24]. CTA Chest The primary role of CTA chest is in evaluating complications of infective endocarditis such as septic pulmonary infarcts and abscesses, paravalvular abscess depending on CTA acquisition technique [13,14], and aortic pseudoaneurysms. CTA chest can also be helpful for preoperative assessment of vasculature and surgical planning [25]. CTA Coronary Arteries CCTA has a role in preoperative planning and assessment of coronary artery disease before surgery [15,17], where the risks of selective coronary angiography may be considerable. Given the well-established high NPV of CCTA, its use for the presurgical assessment of significant coronary artery disease allows for a noninvasive alternative to cardiac catheterization [15,25,26]. Although the use of CCTA and CT-derived fractional flow reserve has not been studied in a patient population with suspected infective endocarditis, extrapolating from the available literature suggests that selective CT-derived fractional flow reserve in patients found to have coronary artery disease on CCTA may play a role in guiding treatment decisions [27,28]. FDG-PET/CT Heart Some recent studies have shown potential clinical value of FDG-PET/CT in infective endocarditis [31].
Infective Endocarditis. In depicting aortic valve pseudoaneurysms, one study showed a sensitivity, specificity, PPV, and NPV of 100%, 87.5%, 91.7%, and 100%, respectively [18]. Compared with echocardiography, CT may be superior in both detecting and visualizing the full extent of a paravalvular Infective Endocarditis abscess, pseudoaneurysm, or fistula, particularly in patients with prosthetic valves [7,10,20-23]. CT may be equivalent or superior to echocardiography in identifying vegetations and valve dehiscence in suspected prosthetic valve endocarditis [7,22,24]. CT may also be utilized to assess for abnormalities in the mobility of mechanical heart valves and to identify causes of mechanical valve dysfunction that are missed on echocardiography and fluoroscopy [24]. CTA Chest The primary role of CTA chest is in evaluating complications of infective endocarditis such as septic pulmonary infarcts and abscesses, paravalvular abscess depending on CTA acquisition technique [13,14], and aortic pseudoaneurysms. CTA chest can also be helpful for preoperative assessment of vasculature and surgical planning [25]. CTA Coronary Arteries CCTA has a role in preoperative planning and assessment of coronary artery disease before surgery [15,17], where the risks of selective coronary angiography may be considerable. Given the well-established high NPV of CCTA, its use for the presurgical assessment of significant coronary artery disease allows for a noninvasive alternative to cardiac catheterization [15,25,26]. Although the use of CCTA and CT-derived fractional flow reserve has not been studied in a patient population with suspected infective endocarditis, extrapolating from the available literature suggests that selective CT-derived fractional flow reserve in patients found to have coronary artery disease on CCTA may play a role in guiding treatment decisions [27,28]. FDG-PET/CT Heart Some recent studies have shown potential clinical value of FDG-PET/CT in infective endocarditis [31].