Evidence Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2022; 14(7): 180-193
Published online Jul 28, 2022. doi: 10.4329/wjr.v14.i7.180
Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review
Diarmaid Hughes, Richard Linchangco, Reza Reyaldeen, Bo Xu
Diarmaid Hughes, Reza Reyaldeen, Bo Xu, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Richard Linchangco, Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Hughes D, Lingchangco R, Reyaldeen R and Xu B were involved in the conceptualization, writing, revision and final approval of the manuscript.
Conflict-of-interest statement: No conflicts of interest to declare for all authors for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Xu, MD, FACC, FASE, Multimodality Imaging Staff Cardiologist, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States. xub@ccf.org
Received: January 5, 2022
Peer-review started: January 5, 2022
First decision: June 16, 2022
Revised: June 26, 2022
Accepted: July 6, 2022
Article in press: July 6, 2022
Published online: July 28, 2022
Processing time: 202 Days and 20.9 Hours
Abstract

There is increasing evidence on the utility of cardiac computed tomography (CCT) in infective endocarditis (IE) to investigate the valvular pathology, the extra-cardiac manifestations of IE and pre-operative planning. CCT can assist in the diagnosis of perivalvular complications, such as pseudoaneurysms and abscesses, and can help identify embolic events to the lungs or systemic vasculature. CCT has also been shown to be beneficial in the pre-operative planning of patients by delineating the coronary artery anatomy and the major cardiovascular structures in relation to the sternum. Finally, hybrid nuclear/computed tomography techniques have been shown to increase the diagnostic accuracy in prosthetic valve endocarditis. This manuscript aims to provide a contemporary update of the existing evidence base for the use of CCT in IE.

Keywords: Infective endocarditis; Cardiac computed tomography; Multimodality cardiac imaging; Cardiovascular structures; Hybrid nuclear

Core Tip: Cardiac computed tomography (CCT) has an expanding role in the management of infective endocarditis (IE). It has been shown to be superior to echocardiography for diagnosing perivalvular complications such as pseudoaneurysms and abscesses. CCT can also diagnose extra-cardiac manifestations of IE such as septic emboli to the lungs. It can assist in pre-operative planning by delineating the coronary anatomy and assessing vascular structures. Herein, we review the role of CCT in IE including the evidence base comparing CCT to echocardiography in diagnosing the valvular complications of IE and the use of CT in IE beyond valvular assessment.