Multimodality imaging of pericardial disease

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Pericardial diseases require accurate diagnosis and management.
• Multimodality imaging has advanced the understanding and treatment of pericardial conditions.

Purpose of the Study:

• To review the role of various imaging modalities in diagnosing and managing pericardial diseases.
• To highlight the specific contributions of echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT).

Main Methods:

• Echocardiography as the first-line test for acute pericarditis.
• Cardiac MRI (CMR) utilizing T2 STIR and late gadolinium enhancement (LGE) for persistent or organizing pericarditis.
• Computed tomography (CT) for procedural planning and assessment of calcification.

Main Results:

• Increased T2 STIR on CMR indicates pericardial edema; increased LGE suggests organizing pericarditis.
• Echocardiographic findings like respiratory septal shift and hepatic vein flow reversal aid in diagnosing constrictive pericarditis.
• Decreased regional longitudinal strain may indicate myocardial tethering in constrictive pericarditis; LGE can predict response to anti-inflammatory therapy.

Conclusions:

• Multimodality imaging, including echocardiography, CMR, and CT, is crucial for diagnosing and managing pericardial diseases.
• Specific imaging features help differentiate conditions and guide therapeutic strategies.
• Advanced imaging techniques improve patient selection for interventions and predict treatment response.