Pericardium: Anatomy and spectrum of disease on computed tomography

Song, Ho Taek; Choi, Yo Won; Jang, Il Soo; Jeon, Seok Chol; Park, Choong Ki; Lee, In Sean; Lee, Jin Seong

doi:10.1016/s0363-0188(02)90003-4

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…Each transaxial CT scan was examined at three levels: mid, mid-low, and low levels of the heart, as shown in Figure 1. As observed by others, the pericardium over part of the left ventricle was, in general, less well visualized than that over the atriums and right ventricle (4). Pericardial effusion was identified as a uniform attenuation consistent with fluid within the pericardial cavity at the levels examined.…”

Section: Grading Of Pericardial Effusionsmentioning

confidence: 71%

“…CT scan is a well-established method to detect the existence and severity of pericardial effusion (4,19), although it is less sensitive than echocardiography to assess its hemodynamic impact (20). The lack of functional consequences by both the clinical presentation and CT criteria of tamponade physiology in patients with ADPKD and a moderate to large degree of pericardial effusion is consistent with a right shift of the pericardial pressure-volume relation and the passive nature of the fluid accumulation (21).…”

Section: Discussionmentioning

confidence: 99%

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Increased Occurrence of Pericardial Effusion in Patients with Autosomal Dominant Polycystic Kidney Disease

Qian

Hartman

King

et al. 2007

Clinical Journal of the American Society of Nephrology

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Background and objectives: Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disease with prominent connective tissue manifestations. A frequent occurrence of asymptomatic pericardial effusion has been observed in patients with ADPKD.Design, setting, participants, & measurements: Consecutive computed tomography scans from 60 patients with ADPKD (group 1), 100 patients without ADPKD and with serum creatinine concentration of >1.1 mg/dl (group 2), and 100 potential kidney donors (group 3) were retrospectively examined. Pericardial effusion was graded from 0 to 4 on the basis of the distance between the parietal and visceral pericardia at mid, mid-low, and low levels of the heart on transaxial computed tomography scan sections.Results: Twenty-one (35%) of 60 patients in group 1 were found to have pericardial effusion, compared with 9 (9%) and 4 (4%) patients in groups 2 and 3, respectively. Ten of the 21 patients with pericardial effusion in group 1 but none of the patients in groups 2 and 3 had moderate to high effusion scores. The presence and severity of pericardial effusion were not associated with age, renal dysfunction, or hypertension. All pericardial effusions were asymptomatic.Conclusions: Pericardial effusion occurs with an increased frequency in patients with ADPKD, possibly as a result of increased compliance of the parietal pericardium. Although frequently moderate to large, these effusions are generally well tolerated and clinically inconsequential.

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Section: Grading Of Pericardial Effusionsmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Increased Occurrence of Pericardial Effusion in Patients with Autosomal Dominant Polycystic Kidney Disease

Qian

Hartman

King

et al. 2007

Clinical Journal of the American Society of Nephrology

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“…viral, bacterial tuberculosis), and hypothyroidism [16,20]. There is thickening of the pericardium associated with a pericardial effusion, but without constriction of the myocardium ( Figure 5).…”

Section: Pericarditis Without Constrictionmentioning

confidence: 99%

Imaging the pericardium: appearances on ECG-gated 64-detector row cardiac computed tomography

O’Leary¹,

Williams²,

Williams³

et al. 2010

BJR

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ABSTRACT. Multidetector row computed tomography (MDCT) with its high spatial and temporal resolution has now become an established and complementary method for cardiac imaging. It can now be used reliably to exclude significant coronary artery disease and delineate complex coronary artery anomalies, and has become a valuable problem-solving tool. Our experience with MDCT imaging suggests that it is clinically useful for imaging the pericardium. It is important to be aware of the normal anatomy of the pericardium and not mistake normal variations for pathology. The pericardial recesses are visible in up to 44% of non-electrocardiogram (ECG)-gated MDCT images. Abnormalities of the pericardium can now be identified with increasing certainty on 64-detector row CT; they may be the key to diagnosis and therefore must not be overlooked. This educational review of the pericardium will cover different imaging techniques, with a significant emphasis on MDCT. We have a large research and clinical experience of ECG-gated cardiac CT and will demonstrate examples of pericardial recesses, their variations and a wide variety of pericardial abnormalities and systemic conditions affecting the pericardium. We give a brief relevant background of the conditions and reinforce the key imaging features. We aim to provide a pictorial demonstration of the wide variety of abnormalities of the pericardium and the pitfalls in the diagnosis of pericardial disease.

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“…CT helps to evaluate the presence or absence of thrombi and also helps to differentiate false-positive lesions (e.g., spontaneous echo contrast in the left atrium) from thrombi (244, 245). Not only can cardiac CT show the anatomy of a normal pericardium, it can also show the area of a lesion three-dimensionally in constrictive pericarditis with calcifications, making it possible to plan treatment such as pericardiectomy (246, 247, 248, 249). Also, cardiac CT allows anatomic evaluation of the pulmonary vein and cardiac veins before procedures are performed to manage arrhythmia (250, 251, 252, 253, 254, 255).…”

Section: Prefacementioning

confidence: 99%

Korean Guidelines for the Appropriate Use of Cardiac CT

et al. 2015

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The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

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Pericardium: Anatomy and spectrum of disease on computed tomography

Cited by 4 publications

References 16 publications

Increased Occurrence of Pericardial Effusion in Patients with Autosomal Dominant Polycystic Kidney Disease

Increased Occurrence of Pericardial Effusion in Patients with Autosomal Dominant Polycystic Kidney Disease

Imaging the pericardium: appearances on ECG-gated 64-detector row cardiac computed tomography

Korean Guidelines for the Appropriate Use of Cardiac CT

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