What imaging techniques should be used to detect intracranial and extracranial mycotic aneurysms?
For intracranial mycotic aneurysms, CT angiography, magnetic resonance angiography, or digital subtraction angiography is reasonable as an initial imaging test. Conventional angiography for detection of suspected intracranial mycotic aneurysms is reasonable in patients with negative CT angiography, magnetic resonance angiography, or digital subtraction angiography. For extracranial mycotic aneurysms, either CT scanning or multislice CT angiography with 3D reconstruction is indicated for initial imaging. Transesophageal echocardiography (TEE) is useful in identifying mycotic aneurysms of the sinus of Valsalva and thoracic aorta.