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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

Constrictive pericarditis. A 67-year-old male with seropositive rheumatoid arthritis. An echocardiogram (images not available) was performed showing pericardial thickening and a small effusion. Paired images a, b, and c represent static images from dynamic MR imaging sequences. Cine tagged MR imaging: Transient fiducial grid-patterned image markers on sagittal images (a) demonstrates failure to dephase after several seconds, indicating nonslippage. Had the pericardium moved with respect to myocardium, the tag lines would have been broken. Instead they deformed only slightly, indicative of pericardial adhesion and providing evidence for constriction. (b, c) Breath-held SSFP long and short axis images demonstrate “septal bounce.” (d) The inferior vena cava is distended at 3.1 cm, providing corroborating evidence for elevated right heart pressures [30].
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fig5: Constrictive pericarditis. A 67-year-old male with seropositive rheumatoid arthritis. An echocardiogram (images not available) was performed showing pericardial thickening and a small effusion. Paired images a, b, and c represent static images from dynamic MR imaging sequences. Cine tagged MR imaging: Transient fiducial grid-patterned image markers on sagittal images (a) demonstrates failure to dephase after several seconds, indicating nonslippage. Had the pericardium moved with respect to myocardium, the tag lines would have been broken. Instead they deformed only slightly, indicative of pericardial adhesion and providing evidence for constriction. (b, c) Breath-held SSFP long and short axis images demonstrate “septal bounce.” (d) The inferior vena cava is distended at 3.1 cm, providing corroborating evidence for elevated right heart pressures [30].

Mentions: MR techniques have emerged which surpass both CT and echocardiography in the diagnosis of pericardial constriction. Morphology is assessed by measuring thickness of the entire pericardium in multiple planes. Function is evaluated by assessing pericardial motion in relation to myocardial motion, typically via steady-state free precession sequences, in combination with cine tagged imaging [16]. In the latter, a transient fiducial linear orthogonal grid pattern is generated by the pulse sequence; the resulting lines referred to as “tag lines.” Lack of normal pericardial “slippage” (i.e., adherence) is inferred when the tag lines fail to dephase (remain unbroken) (Figure 5(a)) [8, 27].


Evaluation of the Pericardium with CT and MR.

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

Constrictive pericarditis. A 67-year-old male with seropositive rheumatoid arthritis. An echocardiogram (images not available) was performed showing pericardial thickening and a small effusion. Paired images a, b, and c represent static images from dynamic MR imaging sequences. Cine tagged MR imaging: Transient fiducial grid-patterned image markers on sagittal images (a) demonstrates failure to dephase after several seconds, indicating nonslippage. Had the pericardium moved with respect to myocardium, the tag lines would have been broken. Instead they deformed only slightly, indicative of pericardial adhesion and providing evidence for constriction. (b, c) Breath-held SSFP long and short axis images demonstrate “septal bounce.” (d) The inferior vena cava is distended at 3.1 cm, providing corroborating evidence for elevated right heart pressures [30].
© Copyright Policy
Related In: Results  -  Collection

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

fig5: Constrictive pericarditis. A 67-year-old male with seropositive rheumatoid arthritis. An echocardiogram (images not available) was performed showing pericardial thickening and a small effusion. Paired images a, b, and c represent static images from dynamic MR imaging sequences. Cine tagged MR imaging: Transient fiducial grid-patterned image markers on sagittal images (a) demonstrates failure to dephase after several seconds, indicating nonslippage. Had the pericardium moved with respect to myocardium, the tag lines would have been broken. Instead they deformed only slightly, indicative of pericardial adhesion and providing evidence for constriction. (b, c) Breath-held SSFP long and short axis images demonstrate “septal bounce.” (d) The inferior vena cava is distended at 3.1 cm, providing corroborating evidence for elevated right heart pressures [30].
Mentions: MR techniques have emerged which surpass both CT and echocardiography in the diagnosis of pericardial constriction. Morphology is assessed by measuring thickness of the entire pericardium in multiple planes. Function is evaluated by assessing pericardial motion in relation to myocardial motion, typically via steady-state free precession sequences, in combination with cine tagged imaging [16]. In the latter, a transient fiducial linear orthogonal grid pattern is generated by the pulse sequence; the resulting lines referred to as “tag lines.” Lack of normal pericardial “slippage” (i.e., adherence) is inferred when the tag lines fail to dephase (remain unbroken) (Figure 5(a)) [8, 27].

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