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Eur Radiol. 2012 Nov;22(11):2407-14. doi: 10.1007/s00330-012-2491-5. Epub 2012 May 24.

ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis.

Author information

1
Department of Radiology, Sahlgrenska University Hospital, Bruna stråket 11b, 41345, Gothenburg, Sweden. erika.fagman@vgregion.se

Abstract

OBJECTIVES:

The aim of this prospective study was to investigate the agreement in findings between ECG-gated CT and transoesophageal echocardiography (TEE) in patients with aortic prosthetic valve endocarditis (PVE).

METHODS:

Twenty-seven consecutive patients with PVE underwent 64-slice ECG-gated CT and TEE and the results were compared. Imaging was compared with surgical findings (surgery was performed in 16 patients).

RESULTS:

TEE suggested the presence of PVE in all patients [thickened aortic wall (n = 17), vegetation (n = 13), abscess (n = 16), valvular dehiscence (n = 10)]. ECG-gated CT was positive in 25 patients (93 %) [thickened aortic wall (n = 19), vegetation (n = 7), abscess (n = 18), valvular dehiscence (n = 7)]. The strength of agreement [kappa (95 % CI)] between ECG-gated CT and TEE was very good for thickened wall [0.83 (0.62-1.0)], good for abscess [0.68 (0.40-0.97)] and dehiscence [0.75 (0.48-1.0)], and moderate for vegetation [0.55 (0.26-0.88)]. The agreement was good between surgical findings (abscess, vegetation and dehiscence) and imaging for ECG-gated CT [0.66 (0.49-0.87)] and TEE [0.79 (0.62-0.96)] and very good for the combination of ECG-gated CT and TEE [0.88 (0.74-1.0)].

CONCLUSION:

Our results indicate that ECG-gated CT has comparable diagnostic performance to TEE and may be a valuable complement in the preoperative evaluation of patients with aortic PVE.

PMID:
22622348
DOI:
10.1007/s00330-012-2491-5
[Indexed for MEDLINE]

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