Learning objectives
To review the normal anatomy of the pericardium and the spectrum of pericardial diseases.
To discuss multimodality imaging approach of pericardial diseases.
Background
The pericardium is a double-walled fibrous sac that surrounds the heart. It can be affected by various diseases including inflammatory, infectious, fibrotic, metabolic, neoplastic as well as congenital malformations. Pericardial pathology may present with vague, overlapping and non-specific clinical symptoms resulting in diagnostic uncertainty. Imaging can play a vital role in establishing the diagnosis and guiding appropriate therapeutic interventions. Various imaging techniques including chest radiography (CXR), transthoracic echocardiography (TTE), computed tomography (CT), cardiovascular magnetic resonance imaging (MRI) and positron emission tomography (PET) are used in...
Findings and procedure details
ANATOMY AND FUNCTION
The pericardium is a double-walled fibrous sac surrounding the heart and consisting of 2 (visceral and parietal) layers. The visceral layer is a serous membrane adherent to epicardium. The parietal pericardium consists of an inner serous and outer fibrocollagenous layers (Fig.1).
The main functions of pericardium are to (Fig.2):
fixate the heart within the thoracic cavity
lubricate the constantly beating heart
isolate the heart from the adjacent organs to reduce the spread of infection.
There is a space between parietal and visceral...
Conclusion
Imaging techniques for diagnosing pericardial diseases vary depending on clinical scenario.
Knowledge of multimodality imaging findings is essential in timely diagnosis and appropriate management (Fig.17).
Personal information and conflict of interest
P. Simkus; Kaunas/LT - nothing to disclose A. Banišauskaitė; Kaunas/LT - nothing to disclose J. Noreikaite; Liverpool/UK - nothing to disclose V. Buroviené; Kaunas/LT - nothing to disclose M. Arzanauskaite; Liverpool/UK - nothing to disclose A. Jankauskas; Kaunas/LT - nothing to disclose M. Gutierrez; Barcelona/ES - nothing to disclose
References
1.Adler Y, Charron P, Imazio M, Badano L, Baron-Esquivias G, Bogaert J, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921–64
2.Peebles CR, Shambrook JS, Harden SP. Pericardial disease--anatomy and function.Br J Radiol. 2011;84 Spec No 3(Spec Iss 3):S324–S337.
3.Ozmen CA, Akpinar MG, Akay HO, et al. Evaluation of pericardial sinuses...