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Endocarditis/Cardiac Mass

Last Updated: 2026-02-02
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  • 1. Clinical Summary

    Series Phase Coverage
    Non-contrast Non-contrast Top of heart to Below heart
    Gated CTA Contrast (30 sec delay) Top of heart to Below heart
    Delayed phase Contrast (70 sec delay) Lung Apices to Diaphragm
    • Endocarditis
    • Cardiac mass
    • Valve vegetation
    • Intracardiac thrombus

  • 2. Patient Prep

    • Position: Supine feet-first
    • NPO Status: NPO 2-4 hours
    • Pre-Medication:
      • HR < 65 preferred. No premedication typically given.

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.6 mL/kg
    Flow Rate 3-4 mL/s
    Duration 35 sec

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Non-valsalva breathing technique, cardiac breathing instruction.
    • Injection duration is fixed 35 sec fixed 30 sec scan delay. Retrospective gating trigger at 30-70% (End sys - end dia). Reconstruct at 5% intervals.
    • Additional Recons: Multi-phase reconstructions. 4-chamber 2-chamber views. Valve-specific reformats
    • 18-20G IV. HR control helpful but not critical

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history
    • Assess all valves for vegetations. Evaluate myocardium for abscess. Look for intracardiac masses. Check for complications
    • Multiple cardiac phases helpful for valve motion. Thin slices for vegetations
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Top of chest Diaphragm N/A N/A AP lateral
Non-contrast Top of heart Below heart N/A 3 mm Flash Non-contrast
Gated CTA Top of heart Below heart 30 sec 0.5-0.625 mm Retrospective ECG gating
Delayed phase Lung Apices Diaphragm 70 sec 1 mm To detect for abscess, vegetation, masses
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Non-contrast Heart 3 mm/3 mm Standard 3 For dense material or calcifications
Axial Gated CTA Heart 0.75 mm/0.5 mm Cardiac 3 Reformatted at best cardiac phase
Axial Gated CTA Heart 1 mm/1 mm Standard 3 Functional series for valve assessment
Axial Delayed Chest 1 mm/1 mm Standard 3 Mass, vegetations