Learning objectives
To describe thecross sectional appearance of normal pericardial anatomy,
related sinuses and recesses,
and potential diagnostic pitfalls.
To understand how CT and MR techniques can identifyconstrictive pericarditis,
pericardial effusions,
neoplasms,
and congenital anomalies.
Background
The pericardium is a two-layered membrane,
composed by the inner serosa (the visceral pericardium) and the outer fibrosa (the parietal pericardium)thatsurroundsthe heart and the origins of the great vessels.
Thoselayers are separated by a small amount of serous fluid,
up to 50 mL,
that is mainly an ultrafiltrate of plasma.
The parietalpericardium extends cranially above level of the aortic root,is continuous with the deep cervical fascia and is attached to the sternum and the diaphragm by ligaments that impede cardiac displacement.
There are somepocketlike structures,...
Imaging findings OR procedure details
Normal pericardium is seen as a thin curvilinear structure that is surrounded on either side by epicardial and mediastinal fat (Fig.
1).
The two pericardial layers are not separately indidualized.
The pericardium is prominently seen adjacent to the right ventricular free wall,
right atrioventricular groove,
inferior aspect of the left ventricle,
and left ventricular apex.
It is visualized less clearly adjacent to the lateral left ventricular wall because of the paucity of fat.Normal pericardiummeasures less than 2 mm incross sectional studies.
The transverse sinus is...
Conclusion
Cardiac imaging is part of the diagnostic workup of patients with pericardial disease.
Cardiac CT and MR allow for an excellent visualization and characterization of pericardial pathology,
making thesecross sectional imaging modalitiescomplimentary to echocardiography,
providing various advantages,
allowing for better characterization of disease.
References
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