講演情報
[I-AEPCJS-1]Optimizing Diagnosis of Infective Endocarditis in Congenital Heart Disease: The Emerging Role of 18F-FDG PET/CT
○Ayako Ishikita1, Tomoyasu Suenaga1, Akiko Nishizaki1, Takamori Kakino1, Ichiro Sakamoto1, Eiko Terashi2, Kenichiro Yamamura2, Kohtaro Abe1 (1.Department of Cardiovascular Medicine, Kyushu University Hospital, 2.Department of Pediatrics, Kyushu University Hospital)
キーワード：
IE、18F-FDG PET/CT、ACHD
Infective endocarditis (IE) in patients with ACHD remains a diagnostic challenge due to difficulties in detecting endocardial lesions by echocardiography. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has shown good diagnostic performance in prosthetic valve IE. We reported its additional diagnostic value in ACHD-associated IE.We retrospectively studied 22 patients with ACHD and clinical suspicion of IE. 18F-FDG PET/CT was performed in addition to the conventional assessment based on the modified Duke criteria. The final IE diagnosis was determined by an expert team during a 3-month clinical course, resulting in 18 patients diagnosed with IE. Seven patients (39%) were diagnosed with definite IE only by initial echocardiography. A 18F-FDG PET/CT assessment revealed endocardial involvement in the other 9 patients, resulting in the diagnosis of definite IE in 16 in total (88%). Right-sided endocardial lesions were more common (n=12, 67%) but rarely identified by echocardiography, whereas 18F-FDG PET/CT revealed right-sided lesions in 9. A negative 18F-FDG PET/CT (n=7, 39%) assessment associated with native valve IE. In 4 patients who were identified with not-IE, neither echocardiography nor 18F-FDG PET/CT showed suspicious of the cardiac involvement. In diagnosis of ACHD-associated IE, characterized by right-sided IE, 18F-FDG PET/CT assessment should be useful. We would like to share our practice presenting several ACHD-IE cases.