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European Radiology

, Volume 22, Issue 11, pp 2407–2414 | Cite as

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

  • Erika FagmanEmail author
  • Sossio Perrotta
  • Odd Bech-Hanssen
  • Agneta Flinck
  • Carl Lamm
  • Lars Olaison
  • Gunnar Svensson
Cardiac

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.

Keywords

Heart valve prosthesis Prosthetic valve endocarditis Aortic valve ECG-gated computed tomography Transoesophageal echocardiography 

Abbreviations

CM

contrast medium

ECG

electrocardiogram

PVE

prosthetic valve endocarditis

TEE

transoesophageal echocardiography

Supplementary material

ESM 1

(MPG 168 kb)

ESM 2

(MPG 272 kb)

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Erika Fagman
    • 1
    Email author
  • Sossio Perrotta
    • 2
  • Odd Bech-Hanssen
    • 3
    • 4
  • Agneta Flinck
    • 1
  • Carl Lamm
    • 1
  • Lars Olaison
    • 5
  • Gunnar Svensson
    • 2
    • 6
  1. 1.Department of RadiologySahlgrenska University HospitalGothenburgSweden
  2. 2.Department of Cardiovascular Surgery and AnaesthesiaSahlgrenska University HospitalGothenburgSweden
  3. 3.Department of Clinical PhysiologySahlgrenska University HospitalGothenburgSweden
  4. 4.Department of CardiologySahlgrenska University HospitalGothenburgSweden
  5. 5.Department of Infectious DiseasesSahlgrenska University HospitalGothenburgSweden
  6. 6.Department of Molecular and Clinical Medicine, Institute of MedicineThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden

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