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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

A 53-year-old woman with extensive cardiac history. (a) Chest radiograph and (b) coronal reconstructed CT image demonstrate dense calcification of the pericardium, predominantly on the right. With history of myocardial infarction, pericarditis, systemic lupus erythematosus, and end-stage renal disease, she has several independent possible explanations for her pericardial calcifications.
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fig4: A 53-year-old woman with extensive cardiac history. (a) Chest radiograph and (b) coronal reconstructed CT image demonstrate dense calcification of the pericardium, predominantly on the right. With history of myocardial infarction, pericarditis, systemic lupus erythematosus, and end-stage renal disease, she has several independent possible explanations for her pericardial calcifications.

Mentions: Noncompliance of the pericardium that results in impaired cardiac function is called constriction [24]. Tamponade and constriction may both lead to the phenomenon of “ventricular interdependence” (refer to explanation in the Section 4) [4]. Furthermore, distinguishing pericardial constriction from restrictive cardiomyopathy can be a diagnostic challenge but is clinically important, as the former is often treatable surgically, but the latter is not [8]. Pericardial calcification is most reliably demonstrated on CT [25]. While pericardial thickening and calcification are findings associated with constriction, they are not always be present (Figure 4). About 50% of patients with pericardial calcification will have constrictive physiology, and about 90% of patients with constrictive physiology will have pericardial calcification [17]. In addition, up to 20% of patients with constriction physiology have no significant pericardial thickening [25, 26]. Pericardial thickening may also be limited to only one portion of the pericardium. If this area of thickening is not included in the field-of-view of echocardiography, a false negative result can occur [8].


Evaluation of the Pericardium with CT and MR.

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

A 53-year-old woman with extensive cardiac history. (a) Chest radiograph and (b) coronal reconstructed CT image demonstrate dense calcification of the pericardium, predominantly on the right. With history of myocardial infarction, pericarditis, systemic lupus erythematosus, and end-stage renal disease, she has several independent possible explanations for her pericardial calcifications.
© Copyright Policy
Related In: Results  -  Collection

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

fig4: A 53-year-old woman with extensive cardiac history. (a) Chest radiograph and (b) coronal reconstructed CT image demonstrate dense calcification of the pericardium, predominantly on the right. With history of myocardial infarction, pericarditis, systemic lupus erythematosus, and end-stage renal disease, she has several independent possible explanations for her pericardial calcifications.
Mentions: Noncompliance of the pericardium that results in impaired cardiac function is called constriction [24]. Tamponade and constriction may both lead to the phenomenon of “ventricular interdependence” (refer to explanation in the Section 4) [4]. Furthermore, distinguishing pericardial constriction from restrictive cardiomyopathy can be a diagnostic challenge but is clinically important, as the former is often treatable surgically, but the latter is not [8]. Pericardial calcification is most reliably demonstrated on CT [25]. While pericardial thickening and calcification are findings associated with constriction, they are not always be present (Figure 4). About 50% of patients with pericardial calcification will have constrictive physiology, and about 90% of patients with constrictive physiology will have pericardial calcification [17]. In addition, up to 20% of patients with constriction physiology have no significant pericardial thickening [25, 26]. Pericardial thickening may also be limited to only one portion of the pericardium. If this area of thickening is not included in the field-of-view of echocardiography, a false negative result can occur [8].

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