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Evaluation of the Pericardium with CT and MR.

Czum JM, Silas AM, Althoen MC - ISRN Cardiol (2014)

Bottom Line: The pericardium plays an important role in optimizing cardiac motion and chamber pressures and serves as a barrier to pathology.In addition to pericardial anatomy and function, this review article covers a variety of pericardial conditions, with mention of potential pitfalls encountered during interpretation of diagnostic imaging.Normal and abnormal appearance of pericardium on CT and MR imaging is emphasized, including dynamic imaging correlates of pericardial pathophysiology.

View Article: PubMed Central - PubMed

Affiliation: Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.

ABSTRACT
The pericardium plays an important role in optimizing cardiac motion and chamber pressures and serves as a barrier to pathology. In addition to pericardial anatomy and function, this review article covers a variety of pericardial conditions, with mention of potential pitfalls encountered during interpretation of diagnostic imaging. Normal and abnormal appearance of pericardium on CT and MR imaging is emphasized, including dynamic imaging correlates of pericardial pathophysiology.

No MeSH data available.


Related in: MedlinePlus

Normal pericardial recesses may be confused with pathology. (a) Contrast-enhanced CT (CECT) demonstrates fluid in the oblique sinus (white arrow). (b, c) Fluid in the superior aortic recess (black arrows). This may appear dense on CT due to contrast blooming and maybe mistaken for soft tissue. (d) Fluid in the left inferior pulmonary venous recess (black arrows).
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fig2: Normal pericardial recesses may be confused with pathology. (a) Contrast-enhanced CT (CECT) demonstrates fluid in the oblique sinus (white arrow). (b, c) Fluid in the superior aortic recess (black arrows). This may appear dense on CT due to contrast blooming and maybe mistaken for soft tissue. (d) Fluid in the left inferior pulmonary venous recess (black arrows).

Mentions: Normal pericardial recesses occur due to the closer apposition of the visceral layer than the parietal layer to the contours of the heart and great vessels. Also, portions of the left atrium are left uncovered by pericardium to a variable degree [11]. These factors result in fluid-filled normal spaces which can be mistaken for pathology [12, 13]. For example, the oblique sinus may simulate an esophageal lesion or paraesophageal lymph node (Figure 2(a)). The normal superior aortic recess may also simulate soft tissue, particularly a mediastinal lymph node, due to blooming artifact caused by intravenous contrast in the adjacent great vessels (Figures 2(b) and 2(c)). The normal pericardial space contains 15–50 mL of fluid, an ultrafiltrate of plasma [8]. Much of this fluid is contained within normal but variable pericardial recesses (Figure 2(d)) [14].


Evaluation of the Pericardium with CT and MR.

Czum JM, Silas AM, Althoen MC - ISRN Cardiol (2014)

Normal pericardial recesses may be confused with pathology. (a) Contrast-enhanced CT (CECT) demonstrates fluid in the oblique sinus (white arrow). (b, c) Fluid in the superior aortic recess (black arrows). This may appear dense on CT due to contrast blooming and maybe mistaken for soft tissue. (d) Fluid in the left inferior pulmonary venous recess (black arrows).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3926415&req=5

fig2: Normal pericardial recesses may be confused with pathology. (a) Contrast-enhanced CT (CECT) demonstrates fluid in the oblique sinus (white arrow). (b, c) Fluid in the superior aortic recess (black arrows). This may appear dense on CT due to contrast blooming and maybe mistaken for soft tissue. (d) Fluid in the left inferior pulmonary venous recess (black arrows).
Mentions: Normal pericardial recesses occur due to the closer apposition of the visceral layer than the parietal layer to the contours of the heart and great vessels. Also, portions of the left atrium are left uncovered by pericardium to a variable degree [11]. These factors result in fluid-filled normal spaces which can be mistaken for pathology [12, 13]. For example, the oblique sinus may simulate an esophageal lesion or paraesophageal lymph node (Figure 2(a)). The normal superior aortic recess may also simulate soft tissue, particularly a mediastinal lymph node, due to blooming artifact caused by intravenous contrast in the adjacent great vessels (Figures 2(b) and 2(c)). The normal pericardial space contains 15–50 mL of fluid, an ultrafiltrate of plasma [8]. Much of this fluid is contained within normal but variable pericardial recesses (Figure 2(d)) [14].

Bottom Line: The pericardium plays an important role in optimizing cardiac motion and chamber pressures and serves as a barrier to pathology.In addition to pericardial anatomy and function, this review article covers a variety of pericardial conditions, with mention of potential pitfalls encountered during interpretation of diagnostic imaging.Normal and abnormal appearance of pericardium on CT and MR imaging is emphasized, including dynamic imaging correlates of pericardial pathophysiology.

View Article: PubMed Central - PubMed

Affiliation: Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.

ABSTRACT
The pericardium plays an important role in optimizing cardiac motion and chamber pressures and serves as a barrier to pathology. In addition to pericardial anatomy and function, this review article covers a variety of pericardial conditions, with mention of potential pitfalls encountered during interpretation of diagnostic imaging. Normal and abnormal appearance of pericardium on CT and MR imaging is emphasized, including dynamic imaging correlates of pericardial pathophysiology.

No MeSH data available.


Related in: MedlinePlus