Anatomic pitfalls of the heart and pericardium

Recent technologic advances have led to more frequent dedicated cross-sectional imaging of the heart. Faster scanning techniques, cardiac gating, and advanced postprocessing software allow improved visualization of finer anatomic details of the heart and pericardium compared with older techniques and software. Use of thin-section computed tomography (CT) or image reformatting in nonaxial planes may be helpful in some cases. The cardiac and pericardial structures are usually readily demonstrated with CT, even if chest CT is performed for evaluation of noncardiac structures. However, radiologists are expected to evaluate all structures on an image, and incidental findings are common. Radiologists must first be familiar with the normal anatomic structures of the heart and pericardium (eg, atria, ventricles, cardiac valves, pericardial recesses, paracardiac structures) to avoid mistaking them for pathologic processes.