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Multimodality Imaging (X-Ray, CT, and MRI) in Pericardial Disease

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Abstract

The accurate diagnosis of pericardial diseases is frequently challenging, and requires an integration of medical history, physical examination, imaging, invasive hemodynamic measurements, hematological testing, pericardial fluid evaluation, and characterization of pericardial biopsy specimens. With the rapid advances in technology, multimodality noninvasive cardiac imaging has assumed a central role in the diagnosis and management of various pericardial conditions, particularly when the clinical findings are equivocal.

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References

  1. Jung W, Zvereva V, Hajredini B, Jackle S. Safe magnetic resonance image scanning of the pacemaker patient: current technologies and future directions. Europace. 2012;14:631–7.

    Article  PubMed  Google Scholar 

  2. Bogaert J, Francone M. Cardiovascular magnetic resonance in pericardial diseases. J Cardiovasc Magn Reson. 2009;11:14.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Wang ZJ, Reddy GP, Gotway MB, Yeh BM, Hetts SW, Higgins CB. CT and MR imaging of pericardial disease. Radiographics. 2003;23 Spec No:S167–80.

    Article  PubMed  Google Scholar 

  4. Spodick DH. Macrophysiology, microphysiology, and anatomy of the pericardium: a synopsis. Am Heart J. 1992;124:1046–51.

    Article  CAS  PubMed  Google Scholar 

  5. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev. 2007;8:253–61.

    Article  CAS  PubMed  Google Scholar 

  6. Hsu YM, Yao NS, Liu JM. Steroid-induced mediastinal lipomatosis with radiographic features of pericardial effusion. Am J Emerg Med. 2000;18:346–8.

    Article  CAS  PubMed  Google Scholar 

  7. Bull RK, Edwards PD, Dixon AK. CT dimensions of the normal pericardium. Br J Radiol. 1998;71:923–5.

    Article  CAS  PubMed  Google Scholar 

  8. Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26:965–1012.e15.

    Article  PubMed  Google Scholar 

  9. Verhaert D, Gabriel RS, Johnston D, Lytle BW, Desai MY, Klein AL. The role of multimodality imaging in the management of pericardial disease. Circ Cardiovasc Imaging. 2010;3:333–43.

    Article  PubMed  Google Scholar 

  10. O’Donnell DH, Abbara S, Chaithiraphan V, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol. 2009;193:377–87.

    Article  PubMed  Google Scholar 

  11. O’Leary SM, Williams PL, Williams MP, et al. Imaging the pericardium: appearances on ECG-gated 64-detector row cardiac computed tomography. Br J Radiol. 2010;83:194–205.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Smith WH, Beacock DJ, Goddard AJ, Bloomer TN, Ridgway JP, Sivananthan UM. Magnetic resonance evaluation of the pericardium. Br J Radiol. 2001;74:384–92.

    Article  CAS  PubMed  Google Scholar 

  13. Cardiac RP. Cardiac MRI: part 2, pericardial diseases. AJR Am J Roentgenol. 2011;197:W621–34.

    Article  Google Scholar 

  14. Merce J, Sagrista-Sauleda J, Permanyer-Miralda G, Evangelista A, Soler-Soler J. Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade. Am Heart J. 1999;138:759–64.

    Article  CAS  PubMed  Google Scholar 

  15. DeCamp Jr MM, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Malignant effusive disease of the pleura and pericardium. Chest. 1997;112:291S–5.

    Article  PubMed  Google Scholar 

  16. Eisenberg MJ, Dunn MM, Kanth N, Gamsu G, Schiller NB. Diagnostic value of chest radiography for pericardial effusion. J Am Coll Cardiol. 1993;22:588–93.

    Article  CAS  PubMed  Google Scholar 

  17. Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet. 2004;363:717–27.

    Article  PubMed  Google Scholar 

  18. Sun JS, Park KJ, Kang DK. CT findings in patients with pericardial effusion: differentiation of malignant and benign disease. AJR Am J Roentgenol. 2010;194:W489–94.

    Article  PubMed  Google Scholar 

  19. Roberts WC. Pericardial heart disease: its morphologic features and its causes. Proc (Bayl Univ Med Cent). 2005;18:38–55.

    Google Scholar 

  20. Meziane MA, Fishman EK, Siegelman SS. CT diagnosis of hemopericardium in acute dissecting aneurysm of the thoracic aorta. J Comput Assist Tomogr. 1984;8:10–4.

    Article  CAS  PubMed  Google Scholar 

  21. Zurick AO, Bolen MA, Kwon DH, et al. Pericardial delayed hyperenhancement with CMR imaging in patients with constrictive pericarditis undergoing surgical pericardiectomy: a case series with histopathological correlation. JACC Cardiovasc Imaging. 2011;4:1180–91.

    Article  PubMed  Google Scholar 

  22. Hoey ET, Gulati GS, Ganeshan A, Watkin RW, Simpson H, Sharma S. Cardiovascular MRI for assessment of infectious and inflammatory conditions of the heart. AJR Am J Roentgenol. 2011;197:103–12.

    Article  PubMed  Google Scholar 

  23. Feng D, Glockner J, Kim K, et al. Cardiac magnetic resonance imaging pericardial late gadolinium enhancement and elevated inflammatory markers can predict the reversibility of constrictive pericarditis after antiinflammatory medical therapy: a pilot study. Circulation. 2011;124:1830–7.

    Article  CAS  PubMed  Google Scholar 

  24. Cummings KW, Bhalla S, Javidan-Nejad C, Bierhals AJ, Gutierrez FR, Woodard PK. A pattern-based approach to assessment of delayed enhancement in nonischemic cardiomyopathy at MR imaging. Radiographics. 2009;29:89–103.

    Article  PubMed  Google Scholar 

  25. Young PM, Glockner JF, Williamson EE, et al. MR imaging findings in 76 consecutive surgically proven cases of pericardial disease with CT and pathologic correlation. Int J Cardiovasc Imaging. 2012;28:1099–109.

    Article  PubMed  Google Scholar 

  26. Taylor AM, Dymarkowski S, Verbeken EK, Bogaert J. Detection of pericardial inflammation with late-enhancement cardiac magnetic resonance imaging: initial results. Eur Radiol. 2006;16:569–74.

    Article  PubMed  Google Scholar 

  27. Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113:1622–32.

    Article  PubMed  Google Scholar 

  28. Oh KY, Shimizu M, Edwards WD, Tazelaar HD, Danielson GK. Surgical pathology of the parietal pericardium: a study of 344 cases (1993–1999). Cardiovasc Pathol. 2001;10:157–68.

    Article  CAS  PubMed  Google Scholar 

  29. Talreja DR, Edwards WD, Danielson GK, et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation. 2003;108:1852–7.

    Article  PubMed  Google Scholar 

  30. Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999;100:1380–6.

    Article  CAS  PubMed  Google Scholar 

  31. Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112:3608–16.

    Article  PubMed  Google Scholar 

  32. Hayashi H, Kawamata H, Machida M, Kumazaki T. Tuberculous pericarditis: MRI features with contrast enhancement. Br J Radiol. 1998;71:680–2.

    Article  CAS  PubMed  Google Scholar 

  33. Breen JF. Imaging of the pericardium. J Thorac Imaging. 2001;16:47–54.

    Article  CAS  PubMed  Google Scholar 

  34. Akiba T, Marushima H, Masubuchi M, Kobayashi S, Morikawa T. Small symptomatic pericardial diverticula treated by video-assisted thoracic surgical resection. Ann Thorac Cardiovasc Surg. 2009;15:123–5.

    PubMed  Google Scholar 

  35. Sechtem U, Tscholakoff D, Higgins CB. MRI of the abnormal pericardium. AJR Am J Roentgenol. 1986;147:245–52.

    Article  CAS  PubMed  Google Scholar 

  36. Jeung MY, Gasser B, Gangi A, et al. Imaging of cystic masses of the mediastinum. Radiographics. 2002;22 Spec No:S79–93.

    Article  PubMed  Google Scholar 

  37. Seelos KC, Funari M, Chang JM, Higgins CB. Magnetic resonance imaging in acute and subacute mediastinal bleeding. Am Heart J. 1992;123:1269–72.

    Article  CAS  PubMed  Google Scholar 

  38. Brown DL, Ivey TD. Giant organized pericardial hematoma producing constrictive pericarditis: a case report and review of the literature. J Trauma. 1996;41:558–60.

    Article  CAS  PubMed  Google Scholar 

  39. Ferguson ER, Blackwell GG, Murrah CP, Holman WL. Evaluation of complex mediastinal masses by magnetic resonance imaging. J Cardiovasc Surg (Torino). 1998;39:117–9.

    CAS  Google Scholar 

  40. Higgins CB, Sakuma H. Heart disease: functional evaluation with MR imaging. Radiology. 1996;199:307–15.

    CAS  PubMed  Google Scholar 

  41. Restrepo CS, Vargas D, Ocazionez D, Martinez-Jimenez S, Betancourt Cuellar SL, Gutierrez FR. Primary pericardial tumors. Radiographics. 2013;33:1613–30.

    Article  PubMed  Google Scholar 

  42. Kaul TK, Fields BL, Kahn DR. Primary malignant pericardial mesothelioma: a case report and review. J Cardiovasc Surg (Torino). 1994;35:261–7.

    CAS  Google Scholar 

  43. Luk A, Ahn E, Vaideeswar P, Butany JW. Pericardial tumors. Semin Diagn Pathol. 2008;25:47–53.

    Article  PubMed  Google Scholar 

  44. van Beek EJ, Stolpen AH, Khanna G, Thompson BH. CT and MRI of pericardial and cardiac neoplastic disease. Cancer Imaging. 2007;7:19–26.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Coskun M, Boyvat F, Agildere AM. CT featuresof a pericardial gossypiboma. Eur Radiol. 1999;9:728–30.

    Google Scholar 

  46. Pineda V, Caceres J, Andreu J, Vilar J, Domingo ML. Epipericardial fat necrosis: radiologic diagnosis and follow-up. AJR Am J Roentgenol. 2005;185:1234–6.

    Article  PubMed  Google Scholar 

  47. Lee HH, Ryu DS, Jung SS, Jung SM, Choi SJ, Shin DH. MRI findings of pericardial fat necrosis: case report. Korean J Radiol. 2011;12:390–4.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Van Son JA, Danielson GK, Schaff HV, Mullany CJ, Julsrud PR, Breen JF. Congenital partial and complete absence of the pericardium. Mayo Clin Proc. 1993;68:743–7.

    Article  PubMed  Google Scholar 

  49. Schiavone WA, O’Donnell JK. Congenital absence of the left portion of parietal pericardium demonstrated by nuclear magnetic resonance imaging. Am J Cardiol. 1985;55:1439–40.

    Article  CAS  PubMed  Google Scholar 

  50. Topilsky Y, Tabatabaei N, Freeman WK, Saleh HK, Villarraga HR, Mulvagh SL. Images in cardiovascular medicine. Pendulum heart in congenital absence of the pericardium. Circulation. 2010;121:1272–4.

    Article  PubMed  Google Scholar 

  51. Psychidis-Papakyritsis P, de Roos A, Kroft LJ. Functional MRI of congenital absence of the pericardium. AJR Am J Roentgenol. 2007;189:W312–4.

    Article  PubMed  Google Scholar 

  52. Gatzoulis MA, Munk MD, Merchant N, Van Arsdell GS, McCrindle BW, Webb GD. Isolated congenital absence of the pericardium: clinical presentation, diagnosis, and management. Ann Thorac Surg. 2000;69:1209–15.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Amgad N. Makaryus MD, FACC, FACP, FASE, FSCCT .

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Agarwal, V., Uretsky, S., Makaryus, A.N. (2014). Multimodality Imaging (X-Ray, CT, and MRI) in Pericardial Disease. In: Herzog, E. (eds) Management of Pericardial Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-06124-5_7

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  • DOI: https://doi.org/10.1007/978-3-319-06124-5_7

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