Magnetic Resonance Imaging in Pericardial Diseases

Maksimović, Ružica; Dill, Thorsten; Seferović, Petar; Ristić, Arsen D.; Alter, Peter; Simeunović, Dejan; Markovic, Z.; Bachmann, Georg; Maisch, Bernhard

doi:10.1007/s00059-006-2894-7

Cited by 29 publications

(13 citation statements)

References 31 publications

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“…Similar to CTA, CMR may also characterize PEff as transudative, exudative or hemorrhagic depending on signal intensity on selected sequences. Transudative effusions generally have low intensity on standard black-blood images and very high intensity on bright-blood cine images [7,40,43], whereas exudative and hemorrhagic PEffs often exhibit high intensity on both used sequences, such as black-blood and cine imaging, due to their high protein content [40]. Lastly, patients with PEff with findings of pericardial constraint may also demonstrate additional findings that are readily assessed by CMR, including septal bounce, respirophasic changes of the ventricular septum, diastolic collapse of the atrial and/or ventricular chambers and inferior vena cava and hepatic vein dilatation, as well as findings of low cardiac output on flow sequences just distal to the aortic or pulmonary valve.…”

Section: • • Acute and Recurrent Pericarditismentioning

confidence: 99%

Modern Advances in Cardiovascular Imaging: Cardiac Computed Tomography and Cardiovascular Mri in Pericardial Disease

et al. 2014

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The pericardium is characterized by a two-layer sac that surrounds the heart and provides an enclosed, lubricated space. Diseases of the pericardium may occur due to active inflammation, scar, calcification or effusion. While clinical, ECG and hemodynamic evaluation have been the established methods for the diagnosis of pericardial disease, advances in cardiac computed tomography and cardiovascular MRI provide complementary tools for diagnostic, prognostic and therapeutic assessment.

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Section: • • Acute and Recurrent Pericarditismentioning

confidence: 99%

Modern Advances in Cardiovascular Imaging: Cardiac Computed Tomography and Cardiovascular Mri in Pericardial Disease

et al. 2014

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“…In der Darstellung lokalisierter Ergüsse sind diese bildgebenden Methoden der Echokardiographie überlegen. [3,23]. Hämorrhagische Perikardergüsse sind häufig Folge einer malignen Perikard erkrankung und somit immer abklärungsbedürftig.…”

Section: Computertomographie Und Magnetresonanztomographieunclassified

Differenzierung von malignen und nichtmalignen, inflammatorischen Perikardergüssen mit Biomarkern

Karatolios

Alter

Maisch

2009

Herz

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Disorders of the pericardium are commonly associated with pericardial effusion. Its etiology comprises a broad spectrum of diseases including also malignancies. Pericardiocentesis, pericardioscopy and targeted epicardial biopsy with consecutive pericardial fluid and epicardial biopsy analysis by cytology, molecular biology and immunology establish the underlying etiology in the majority of cases. Of particular therapeutic and prognostic importance is the definite differentiation of malignant pericardial effusion from benign pericardial effusion. Biomarkers for cardiovascular diseases can be divided into biochemical, histological, immunologic, serologic and molecular markers as well as imaging biomarkers. Biomarkers have proven to be useful in the diagnosis, differential diagnosis and prognosis of ischemic heart disease and heart failure. With respect to pericardial disorders, a comprehensive approach combining clinical information, imaging biomarkers, biomarkers of pericardial effusion and analysis of epicardial biopsies often leads to the definite etiologic diagnosis of pericardial effusion. Computed tomography and magnetic resonance imaging allow further characterization of the effusion and, of note, also of the surrounding tissue, which is of particular interest in case of malignancies. Biomarkers of pericardial effusion include biochemical markers, autoantibodies, tumor markers, and cytokines. Analysis of pericardial fluid specific gravity, protein level and lactate dehydrogenase (LDH) separates transudates from exsudates. High adenosine deaminase levels (ADA) and low levels of carcinoembryonic antigen (CEA) in the pericardial effusion are observed in tuberculous pericarditis allowing the differentiation from malignant pericardial effusion. Additional markers, such as interferon and lysozyme, have also been suggested for the diagnosis of tuberculous pericarditis. Tumor markers in pericardial fluid have been used to diagnose malignant pericarditis. CEA levels are significantly higher in malignant than benign effusion. By a cutoff level of CEA > 5 ng/ml the diagnostic sensitivity and specificity are 75% and 100%, respectively, in the diagnosis of malignant pericardial effusion. Further analysis of cytokines and mediators, serologic, immunologic and inflammatory markers may help to understand the pathophysiology of the pericardial disease and provide useful diagnostic information.

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“…[18]. Die Durchführung mit Kontrastmittel (Gadolinium) ermöglicht die Abbildung perikardialer inflammatorischer Regionen durch Nachweis eines "late enhancements" [1].…”

Section: Diagnostikunclassified

Neue Möglichkeiten der Diagnostik und Therapie der Perikarditis

Maisch

Karatolios

2008

Internist

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Pericarditis is an inflammatory disorder of the pericardium with or without an associated pericardial effusion. The diagnosis is based on the clinical manifestations and typical ECG changes. Echocardiography is essential to reveal the size of the pericardial effusion and to determine its hemodynamic significance. The precise etiology of pericarditis may be established by pericardiocentesis, pericardioscopy and targeted biopsy and consecutive pericardial fluid and biopsy analysis by molecular biology, cytology, microbiology and immunological techniques. Non steroidal anti-inflammatory drugs and/or colchicine are the mainstay of anti-inflammatory treatment of pericarditis. Systemic corticoid treatment should be restricted to patients with associated autoimmune disorder, relapsing pericarditis and as a complementary therapy in tuberculous pericarditis. In autoreactive pericarditis intrapericardial instillation of triamcinolone is effective with few side effects. In malignant pericarditis the intrapericardial administration of cisplatin prevents early recurrences.

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Magnetic Resonance Imaging in Pericardial Diseases

Cited by 29 publications

References 31 publications

Modern Advances in Cardiovascular Imaging: Cardiac Computed Tomography and Cardiovascular Mri in Pericardial Disease

Modern Advances in Cardiovascular Imaging: Cardiac Computed Tomography and Cardiovascular Mri in Pericardial Disease

Differenzierung von malignen und nichtmalignen, inflammatorischen Perikardergüssen mit Biomarkern

Neue Möglichkeiten der Diagnostik und Therapie der Perikarditis

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