Magnetic resonance imaging in the management of pericardial disease

The pericardium, although seldom the primary cause of systemic illness, can be involved in almost every type of disease. Pericardial involvement may be subtle and escape detection unless specifically sought, or it can overshadow features of the underlying systemic disease. Suspected pericardial disease is usually initially evaluated with echocardiography. However, magnetic resonance imaging can offer additional valuable information. In addition to the excellent resolution and unlimited imaging planes available for visualization of the entire pericardial sac, the wide field of view allows for evaluation of involvement of adjacent cardiac structures. Dynamic functional imaging and tissue characterization with and without contrast can further characterize disease and provide information regarding concomitant myocardial disease and effects on cardiac motion. The treatment of specific pericardial conditions ultimately depends on the underlying disease process. Magnetic resonance imaging can provide useful information to aid in diagnosis, management, and guidance of therapy for pericardial disease.