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CT in tuberculous constrictive pericarditis.

I B Suchet1, T A Horwitz

  • 1Department of Diagnostic Radiology, Baragwanath Hospital, Johannesburg, South Africa.

Journal of Computer Assisted Tomography
|May 1, 1992
PubMed
Summary

Computed tomography (CT) effectively differentiates constrictive pericarditis from restrictive cardiomyopathy. Pericardial thickening on CT is a key indicator, reducing the need for invasive diagnostic procedures.

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Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Constrictive pericarditis (CP) and restrictive cardiomyopathy share impaired diastolic filling and similar clinical presentations.
  • Differentiating between these conditions noninvasively is crucial for appropriate patient management.

Purpose of the Study:

  • To evaluate the diagnostic value of computed tomography (CT) in distinguishing between constrictive pericarditis and restrictive cardiomyopathy.

Main Methods:

  • Retrospective review of CT scans from 212 patients presenting with symptoms of CP or restrictive cardiomyopathy.
  • Analysis focused on identifying pericardial thickening and other CT findings indicative of CP.

Main Results:

  • Pericardial thickening (≥3 mm) was observed in 157 patients with proven tuberculous CP; 2 children had thickening between 2-3 mm.

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  • CT accurately identified constrictive pericarditis, with pericardial thickening being the primary diagnostic sign.
  • Confirmatory CT signs included inferior vena cava dilatation (97%) and interventricular septum deviation (15%).

    • Conclusions:

    • Computed tomography is a reliable noninvasive tool for diagnosing constrictive pericarditis.
    • CT findings, particularly pericardial thickening, can obviate the need for invasive cardiac catheterization and endomyocardial biopsy in most cases.