Abstract：
This document on cardiovascular infection, including infective endocarditis, is the first in the American Society of Nuclear Cardiology Imaging Indications (ASNC I2) series to assess the role of radionuclide imaging in the multimodality context for the evaluation of complex systemic diseases with multi-societal involvement including pertinent disciplines. A rigorous modified Delphi approach was used to determine consensus clinical indications, diagnostic criteria, and an algorithmic approach to diagnosis of cardiovascular infection including infective endocarditis. Cardiovascular infection incidence is increasing and is associated with high morbidity and mortality. Current strategies based on clinical criteria and an initial echocardiographic imaging approach are effective but often insufficient in complicated cardiovascular infection. Radionuclide imaging with 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (CT) and single photon emission computed tomography/CT leukocyte scintigraphy can enhance the evaluation of suspected cardiovascular infection by increasing diagnostic accuracy, identifying extracardiac involvement, and assessing cardiac implanted device pockets, leads, and all portions of ventricular assist devices. This advanced imaging can aid in key medical and surgical considerations. Consensus diagnostic features include focal/multi-focal or diffuse heterogenous intense 18F-FDG uptake on valvular and prosthetic material, perivalvular areas, device pockets and leads, and ventricular assist device hardware persisting on non-attenuation corrected images. There are numerous clinical indications with a larger role in prosthetic valves, and cardiac devices particularly with possible infective endocarditis or in the setting of prior equivocal or non-diagnostic imaging. Illustrative cases incorporating these consensus recommendations provide additional clarification. Future research is necessary to refine application of these advanced imaging tools for surgical planning, to identify treatment response, and more.
摘要：
这份关于心血管感染的文件,包括感染性心内膜炎,是美国核心脏病学影像学适应症学会（ASNCI2）系列中第一个评估放射性核素成像在多模态环境中的作用，以评估包括相关学科在内的多社会参与的复杂全身性疾病。严格的改良德尔菲法用于确定共识临床适应症，诊断标准,和诊断心血管感染包括感染性心内膜炎的算法方法。心血管感染的发病率正在增加，并且与高发病率和死亡率相关。基于临床标准和初始超声心动图成像方法的当前策略是有效的，但在复杂的心血管感染中通常不足。18F-氟代脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（CT）和单光子发射计算机断层扫描/CT白细胞闪烁显像的放射性核素显像可以通过提高诊断准确性来增强对可疑心血管感染的评估，确定心外受累,并评估心脏植入装置袋，线索,和心室辅助装置的所有部分。这种先进的成像可以帮助关键的医疗和手术考虑。共识诊断特征包括瓣膜和假体材料上的局灶性/多灶性或弥漫性异质强烈18F-FDG摄取，瓣周区，设备口袋和引线，和心室辅助设备硬件坚持非衰减校正图像。有许多临床适应症在人工瓣膜中具有更大的作用，和心脏设备，特别是可能的感染性心内膜炎或在先前的模棱两可或非诊断成像的背景下。纳入这些协商一致建议的说明性案例提供了进一步的澄清。未来的研究是必要的，以完善这些先进的成像工具的手术计划的应用，为了确定治疗反应，还有更多.
