Table 3 Key points of MSCT findings in IE
From: Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay
MSCT Imaging findings | Advantages | Drawbacks | |
|---|---|---|---|
Vegetation | Hypodense homogeneous irregular mass on valve or endocardial structures. | - Accuracy of detection similar to echocardiography. - Vegetation size correlates on both MSCT and echocardiography. | Echocardiography is superior in detecting small vegetations. |
Perforation | Defect in the leaflet. | Echocardiography is superior in detecting perforations. | |
Valvular aneurysm | Loss of the homogenous curvature of the leaflet | ||
Valvular thickening | Leaflet thickened | Difficult to assess when lesions are degenerative or calcified. | |
Peri-valvular abscess | Peri-valvular collection of liquid density. Thick layer of inflammatory tissue enhanced by contrast media | - Excellent detection capacity. - 3D reconstruction MSCT is superior to TEE in detecting extension to the mediastinal structures. | |
Pseudoaneurysm | Abnormal cavity close to the valve enhancing concomitantly with the cardiac or aortic lumen | - Excellent detection capacity. - 3D reconstruction MSCT is superior to TEE in detecting extension to the mediastinal structures. | |
Fistula | Communication between neighbouring cavities | - Excellent detection capacity. - 3D reconstruction MSCT is superior to TEE in detecting extension to the mediastinal structures. | |
Prosthetic valve | Disinsertion of a prosthetic valve Vegetation on the prosthetic valve | - 3D reconstruction possible - Dynamic assessment of leaflet motion | Metallic artefacts |