title: Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay.
abstract: OBJECTIVE
  The goals of this pictorial essay are: (1) to set out a multislice computed tomography (MSCT) imaging protocol to assess infective endocarditis (IE); (2) to give an MSCT overview of valvular and peri-valvular involvement during IE; (3) to give a CT overview of septic embolism and infectious pseudoaneurysms during IE.
  
  
  METHODS
  MSCT acquisition protocols to assess IE are performed in two different phases: the first acquisition, under electrocardiography (ECG) gating, covers the cardiac structures during first-pass iodine injection; the second acquisition covers the thorax, abdomen, pelvic and cerebral regions.
  
  
  RESULTS
  Valvular and peri-valvular lesions during IE are: vegetation-a hypodense, homogeneous, irregular mass on a valve or endocardial structure; perforation-a defect in the leaflet; valvular aneurysm-loss of the homogenous curvature of the leaflet; valvular thickening; peri-valvular abscess; pseudoaneurysm; fistula and disinsertion of a prosthetic valve. Extra-cardiac location could involve all organs.
  
  
  CONCLUSIONS
  MSCT can be considered as a useful complement in visualising the cardiac lesions of IE if echocardiography is inconclusive. MSCT is the only imaging modality that provides assessment of valvular and peri-valvular involvement, extra-cardiac lesions, and non-invasive evaluation of the coronary artery anatomy, simultaneously.
  
  
  CONCLUSIONS
  • MSCT provides assessment of coronary anatomy, cardiac and extra-cardiac lesions. • MSCT represents an alternative to echocardiography during IE. • Surgical valve replacement is usually required if vegetation is >10 mm. • Peri-valvular extension (abscesses, pseudoaneurysm and fistulae) required surgical treatment.
authors.affiliation: Service de Radiologie Adultes, Centre Hospitalier Universitaire Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Grob
authors.forename: Franck
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authors.lastname: Thuny
authors.forename: Chloe
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authors.lastname: Villacampa
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authors.lastname: Flavian
authors.forename: Jean Yves
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authors.forename: Didier
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authors.lastname: Raoult
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authors.lastname: Casalta
authors.forename: Gilbert
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authors.lastname: Habib
authors.forename: Guy
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authors.forename: Alexis
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authors.lastname: Jacquier