Learning objectives
Review of the normal and variant pericardial recesses.
To depict the importance to differentiate pericardial recesses from common cystic mediastinal masses and lymphadenopathy.
To emphasize the impact of pericardial recesses on oncologic imaging.
Background
The pericardial cavity has several recesses which can be demonstrated on CT and MR imaging.
The pericardial recesses close proximity to surrounding mediastinal structures means that they can be easily misinterpreted as lymphadenopathy or other mediastinal pathology.
It is important for radiologists to have knowledge of the normal pericardial recesses in order to avoid incorrect radiological diagnosis or oncological staging of tumors.
Findings and procedure details
The pericardium encases the heart and superiorly envelops the origin of the superior vena cava,
ascending aorta and the pulmonary trunk.
Its function is to protect the heart and facilitate cardiac motion within the thoracic cavity.
The pericardium encloses the heart and the juxtacardiac parts of great vessels and consists of two components:
Fibrous (outer) pericardium
Serosal (inner) pericardium
Theinner serosalayer has two components:visceraland parietal.
The visceral layer,
or epicardium,
surrounds the heart and great vessels,
and the parietal layer lines the fibrous component.The spaces...
Conclusion
Pericardial recesses mimic various mediastinal lymph nodes.
Following are the differentiating features on cross sectional imaging.
Multiplanar reformatting and thin slice reconstruction helps to better differentiate recesses from lymph nodes.
Radiologist should be familiar with the expected radiological of anatomy of pericardial recesses in order to avoid incorrect radiological diagnosis or oncological staging of tumors,
which could significantly change patient management.
Personal information
Dr.
Pedro Naime Barroso de Araujo
MD.
Radiology
São Paulo,
Brazil
Email:
[email protected]
References
Mylene T.
Truong,
Jeremy J.
Erasmus,
Gregory W.
Gladish,
Bradley S.
Sabloff,
Edith M.
Marom,
Jhon E.
Madewell,
Marvin H.
Chasen,
Reginald F.
Mundane.
Anatomy of pericardial Recesses on Multidetector CT: Implications for Oncologic Imaging.
AJR 2003;181:1109-1113 0361-803X/03/1814-1109.
Reinhard Groell,
MD.
Gottfried J Schaffler,
MD.
Rainer Reinmueller,
MD.
Pericardial Sinuses and Recesses: Findings at Electrocardiographically Triggered Electron-Beam CT.
Radiology 1999; 212:69-73.
Lynn S.
Broderick,
MD .
Gregory N.
Brooks,
MD,
PhD .
Fanet E.
Kuhlman,
MD,
MS.
Anatomic Pitfalls of Heart and Pericardium.
RadioGraphics 2005;...
