Type:
Educational Exhibit
Keywords:
Education, CT-High Resolution, CT, Oncology, Mediastinum, Anatomy, Cancer, Metastases
Authors:
P. N. B. D. A. Araujo, A. V. B. Pavani, F. R. Lucchesi, G. Meirelles, M. R. T. Garcia; Sao Paulo/BR
DOI:
10.26044/ecr2019/C-2543
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
The inner serosa layer has two components: visceral and parietal.
The visceral layer,
or epicardium,
surrounds the heart and great vessels,
and the parietal layer lines the fibrous component. The spaces between these two layers forming the pericardial sinuses or recesses,
which are visualized when distended with fluid.
The reflections of the serosal layer are arranged as two tubes:
- One encasing the aorta and the pulmonary trunk: The pericardial cavity proper
- Other encasing the superior and the inferior vena cava and the pulmonary veins: The oblique sinus
- The passage between the two tubes: The transverse sinus
As the pericardium extends along the great vessels,
the pericardial cavity proper, transverse and the oblique sinuses form recesses. Fig. 1
Transverse sinus (TS) —> Located posterior to the ascending aorta and the pulmonary trunk and superior to the left atrium. Is divided into:
Oblique sinus (OS) —> Located postero-superior to the left atrium and posteromedial to the left superior pulmonary vein.
Is composed for:
- Posterior pulmonic recess Fig. 6
Pericardial cavity proper —> The recesses arising are:
- Pulmonary venous recess (right and left) Fig. 7
- Post-caval recess Fig. 8
Correlations
- Pericardial recesses x Lymph nodes Fig. 9
- Pericardial recesses X Necrotic lymph nodes Fig. 10
- MRI and CT correlations Fig. 11