PVE is associated with perivalvular involvement and tissue destruction and clearly has an added value for pseudo-aneurysms and abscesses. With PET/CT, up to 90% of the undecided cases of PVE could be reclassified and misdiagnosis can be reduced. These methods should not replace the more classic imaging techniques but should be integrated into decision algorithms. Using PET/CT could increase the area under the curve in the receiver-operator-curve analysis to 0.71 and even 0.90 in PVE. Prolonged antibiotic treatment in patients with PVE, however, leads to lowered inflammatory activity, which could serve as a confounder. In cases of doubt, PET/CT could be complemented with WBC scintigraphy. It is also important to keep in mind that echocardiography or cardiac CT is needed to document vegetation in PVE.
Author(s) Details:
Wilhelm P. Mistiaen,
Department of Health and Social Care, Artesis Plantijn University College Antwerp, Belgium and Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.