Imaging findings of pericardial metastasis on chest computed tomography

To assess imaging features of pericardial metastases on chest computed tomography (CT) scanning.

This institutional review board-approved retrospective study included 60 patients (24 men, 36 women; mean age, 62 [SD, 13] years). All chest CT scans for these patients were reviewed independently for presence of pericardial effusion, irregularity, enhancement, nodules, and masses and presence of coexistent cardiac lesions (metastasis). Location of pericardial nodules and irregularity and type and location of primary malignancy were recorded.

Of these 60 patients with pericardial metastasis, 54 (90%) had pericardial effusion (small in 23/54 and moderate to large in 31/54 patients); 14 (23%) of 60 patients had nodules or masses in the pericardium; 21 (35%) of 60 had pericardial enhancement; and 27 (45%) of 60 had pericardial thickening. Prepericardial lymph nodes were present in 39 (65%) of 60 patients. The most common location of pericardial nodules and irregularity was along the free wall of the right ventricle (6/14) and right atrioventricular groove (5/14). Other 3 of 14 patients had pericardial nodule over the left ventricle, in oblique sinus of the pericardium, and interventricular groove each.

Most frequent CT features of pericardial metastases include pericardial effusion, prepericardial lymph nodes, and pericardial thickening, enhancement, and nodules in order of decreasing frequency.