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MR imaging of the transverse sinus of the pericardium
1Department of Radiology, University of California, San Francisco, School of Medicine 94143-0628.
Abstract:
On MR images of the chest, a low-signal-intensity band is often seen between the ascending aorta and left atrium in the transverse plane, and between the right pulmonary artery and left atrium in the coronal and sagittal planes. CT and MR of cadavers, with injection of contrast media into the pericardial space, confirmed that this structure was the transverse sinus of the pericardium. Retrospective review of MR studies in 45 patients without evidence of pericardial disease showed the transverse sinus of the pericardium in 80% (32/40) of transverse ECG-gated images, 78% (7/9) of sagittal ECG-gated images, and 67% (14/21) of coronal ECG-gated images. Nongated studies showed the sinus infrequently. Knowledge of the three-dimensional anatomy of the transverse sinus of the pericardium and of its typical MR appearance should allow its recognition and preclude misinterpretation.
Insights
The transverse sinus of the pericardium is a common finding on chest MR imaging. Understanding its typical appearance on cardiac MRI helps radiologists avoid misinterpreting this normal anatomical structure.
Area of Science:
- Radiology
- Anatomy
- Medical Imaging
Background:
- A low-signal-intensity band is frequently observed on chest MR images.
- This band appears between the ascending aorta and left atrium (transverse plane) or right pulmonary artery and left atrium (coronal/sagittal planes).
Purpose of the Study:
- To identify and characterize the transverse sinus of the pericardium on MR images.
- To confirm the anatomical structure using CT and MR with contrast injection in cadavers.
- To assess the prevalence of the transverse sinus on ECG-gated MR images in patients without pericardial disease.
Main Methods:
- Cadaveric CT and MR imaging with pericardial space contrast injection.
- Retrospective review of ECG-gated MR studies in 45 patients without pericardial disease.
- Analysis of transverse, sagittal, and coronal imaging planes.
Main Results:
- Cadaver studies confirmed the low-signal band as the transverse sinus of the pericardium.
- The transverse sinus was visualized in 80% of transverse, 78% of sagittal, and 67% of coronal ECG-gated MR images.
- Nongated MR studies showed the sinus infrequently.
Conclusions:
- The transverse sinus of the pericardium is a common finding on cardiac MRI.
- Familiarity with its three-dimensional anatomy and typical MR appearance is crucial for accurate interpretation.
- Recognition of the transverse sinus can prevent misdiagnosis of pericardial disease.