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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 63-year-old male with cutaneous T-cell lymphoma, refractory to all modalities including total body electron irradiation. Axial (a) and sagittal (b) CECT images show a mass situated over the right ventricle, appearing to arise from the anterior pericardium (arrows). (c) On spoiled gradient postcontrast axial MR the mass enhances homogeneously and straddles the pericardium (arrow). (d) Double inversion recovery sagittal image demonstrates that the mass has invaded through the pericardium into the epicardial fat (arrow).
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fig10: A 63-year-old male with cutaneous T-cell lymphoma, refractory to all modalities including total body electron irradiation. Axial (a) and sagittal (b) CECT images show a mass situated over the right ventricle, appearing to arise from the anterior pericardium (arrows). (c) On spoiled gradient postcontrast axial MR the mass enhances homogeneously and straddles the pericardium (arrow). (d) Double inversion recovery sagittal image demonstrates that the mass has invaded through the pericardium into the epicardial fat (arrow).

Mentions: Pericardial metastases are more common than suspected on clinical grounds, as they are found in 1.5 to 22% of autopsy specimens of patients who died from cancer [40]. In other words, patients usually die of their disease before the pericardial metastases become physiologically important. The most common primary malignancies with pericardial metastases are breast, lung, lymphoma and melanoma, but any widely metastatic malignancy may implant on the pericardium (Figure 10) [4]. Metastasis to the pericardium occurs by both hematogenous and lymphatic routes. Pericardial metastatic disease may cause constriction by encasement of the heart. Alternatively, it may impair cardiac function via malignant effusion and tamponade physiology [33]. More commonly, as with primary pericardial neoplasm, symptoms are insidious. Imaging findings typically include nodular pericardial thickening with enhancement and effusion [19, 35]. These are of course non-specific findings and definitive diagnosis can be difficult without biopsy [41].


Evaluation of the Pericardium with CT and MR.

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

A 63-year-old male with cutaneous T-cell lymphoma, refractory to all modalities including total body electron irradiation. Axial (a) and sagittal (b) CECT images show a mass situated over the right ventricle, appearing to arise from the anterior pericardium (arrows). (c) On spoiled gradient postcontrast axial MR the mass enhances homogeneously and straddles the pericardium (arrow). (d) Double inversion recovery sagittal image demonstrates that the mass has invaded through the pericardium into the epicardial fat (arrow).
© Copyright Policy
Related In: Results  -  Collection

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

fig10: A 63-year-old male with cutaneous T-cell lymphoma, refractory to all modalities including total body electron irradiation. Axial (a) and sagittal (b) CECT images show a mass situated over the right ventricle, appearing to arise from the anterior pericardium (arrows). (c) On spoiled gradient postcontrast axial MR the mass enhances homogeneously and straddles the pericardium (arrow). (d) Double inversion recovery sagittal image demonstrates that the mass has invaded through the pericardium into the epicardial fat (arrow).
Mentions: Pericardial metastases are more common than suspected on clinical grounds, as they are found in 1.5 to 22% of autopsy specimens of patients who died from cancer [40]. In other words, patients usually die of their disease before the pericardial metastases become physiologically important. The most common primary malignancies with pericardial metastases are breast, lung, lymphoma and melanoma, but any widely metastatic malignancy may implant on the pericardium (Figure 10) [4]. Metastasis to the pericardium occurs by both hematogenous and lymphatic routes. Pericardial metastatic disease may cause constriction by encasement of the heart. Alternatively, it may impair cardiac function via malignant effusion and tamponade physiology [33]. More commonly, as with primary pericardial neoplasm, symptoms are insidious. Imaging findings typically include nodular pericardial thickening with enhancement and effusion [19, 35]. These are of course non-specific findings and definitive diagnosis can be difficult without biopsy [41].

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