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MR imaging findings in 76 consecutive surgically proven cases of pericardial disease with CT and pathologic

Phillip M Young1, James F Glockner, Eric E Williamson

  • 1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA. young.phillip@mayo.edu

The International Journal of Cardiovascular Imaging
|July 8, 2011
PubMed

Insights

State-of-the-art Magnetic Resonance (MR) imaging effectively differentiates chronic recurrent pericarditis, constrictive pericarditis, and pericardial tumors. Key findings include distinct pericardial thickness, IVC diameter, and septal bounce patterns.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Pericardial diseases, including chronic recurrent pericarditis, constrictive pericarditis, and pericardial tumors, require accurate diagnostic methods.
  • Distinguishing between these conditions is crucial for appropriate patient management and treatment.

Purpose of the Study:

  • To evaluate the utility of advanced Magnetic Resonance (MR) imaging sequences in characterizing patients with surgically confirmed pericardial disease.
  • To identify distinct MR imaging findings associated with different types of pericardial pathology.

Main Methods:

  • Retrospective review of patients who underwent pericardiectomy and preoperative MR imaging over a 5-year period.
  • Analysis of MR findings including pericardial thickness, inferior vena cava (IVC) diameter, effusions, edema, enhancement, and septal bounce.
  • Correlation of imaging findings with confirmed diagnoses of chronic recurrent pericarditis, constrictive pericarditis, or pericardial tumor.

Main Results:

  • Patients with constrictive pericarditis exhibited a larger IVC diameter (3.1 ± 0.4 cm) compared to those with recurrent pericarditis without constriction (2.0 ± 0.4 cm).
  • Pericardial thickness varied, with higher mean thickness noted in constrictive cases with calcification (9.2 ± 7.0 cm).
  • Septal bounce was significantly more prevalent in constrictive pericarditis (86%) than in chronic recurrent pericarditis (19%). Gadolinium enhancement was common in both (94% vs. 76%).

Conclusions:

  • Advanced MR imaging techniques provide significant and distinct findings for differentiating chronic recurrent pericarditis, constrictive pericarditis, and pericardial tumors.
  • Specific MR parameters like IVC diameter and septal bounce are valuable in diagnosing constrictive pericarditis.
  • MR imaging is a powerful tool for evaluating pericardial disease, aiding in preoperative diagnosis and surgical planning.

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