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Published on: April 18, 2013
Review of pericardial disease on computed tomography
Nina L J Terry1, Padma P Manapragada1, Muhammad Usman Aziz1
1University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA.
Insights
Computed tomography (CT) complements echocardiography for pericardial disease assessment, offering superior visualization of difficult-to-image areas. Understanding the strengths of both imaging modalities ensures accurate diagnosis and evaluation of pericardial conditions.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Echocardiography is the traditional standard for evaluating cardiac and pericardial diseases.
- Advancements in computed tomography (CT) have established it as a valuable tool for pericardial imaging.
Purpose of the Study:
- To compare the strengths and weaknesses of echocardiography and CT in assessing pericardial disease.
- To highlight the complementary roles of these imaging modalities in clinical practice.
Main Methods:
- Review of the capabilities of echocardiography and CT in pericardial imaging.
- Discussion of CT advantages, including larger field of view, multiplanar reconstruction, and improved soft tissue/fluid discrimination.
- Consideration of CT's reduced operator dependency and improved imaging of specific regions like the right pericardium.
- Evaluation of EKG gating's role in reducing motion artifact and enabling functional assessment with CT.
Main Results:
- CT offers advantages over echocardiography in visualizing certain pericardial regions and differentiating tissues.
- EKG gating in CT reduces motion artifact, aiding functional evaluation.
- Echocardiography remains superior for real-time imaging of cardiac and valve motion.
Conclusions:
- CT is a valuable adjunct to echocardiography for pericardial disease evaluation.
- Skilled cardiac imagers must understand the distinct strengths and limitations of both CT and echocardiography.
- Integrated use of both modalities optimizes the definition and assessment of pericardial disease.
Abstract:
Echocardiography has long been the mainstay in the evaluation of cardiac and pericardial disease. As computed tomography (CT) has advanced, it has become a valuable partner in the imaging of the pericardium. The advantages of CT include a larger field of view, multiplanar reconstruction and increased discrimination between various soft tissues and fluids. CT is less operator dependent and can more easily, and reproducibly, image areas of the pericardium for which echocardiography has poor windows such as the right pericardium. The introduction of EKG gating has decreased cardiac motion artifact and can allow functional evaluation although echocardiography remains the primary source of real-time imaging of cardiac and valve motion. It is essential for the skilled cardiac imager to understand the strengths and weaknesses of CT and its role in the definition and assessment of pericardial disease.
