Multiple Imaging Modalities in the Diagnosis of Infective Endocarditis

Infective endocarditis (IE) is an inflammatory disease caused by the infection of the endocardium or heart valves by pathogenic microorganisms. It is characterized by diagnostic challenges, difficult treatment, and high mortality. Multimodal imaging techniques, including echocardiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine imaging, play a crucial role in the diagnosis of IE. Echocardiography is the first-line imaging modality for suspected IE. Cardiac CT, with its excellent spatial resolution and three-dimensional (3D) reconstruction capabilities, is helpful in detecting paravalvular abscesses, fistulas, and pseudoaneurysms. MRI has advantages in identifying neurological complications and assessing myocardial involvement. Nuclear imaging demonstrates high specificity in detecting prosthetic valve IE and device-related infections. These imaging techniques are important in detecting perivalvular complications, evaluating local and distant spread of infection, and guiding therapeutic interventions, thereby enhancing the diagnostic and therapeutic management of IE.