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Epipericardial fat pad: CT findings.

M R Paling1, B R Williamson

  • 1Department of Radiology, University of Virginia Medical Center, Charlottesville 22908.

Radiology
|November 1, 1987
PubMed
Summary

Epicardial fat pads can mimic cardiac abnormalities on chest X-rays. Cardiomegaly alone can also create a false appearance of a cardiac fat pad.

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Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Thoracic Imaging

Background:

  • Epicardial and mediastinal fat can create a cardiac fat pad appearance on lateral chest radiographs.
  • This finding is typically located in the anterior cardiophrenic angle.

Purpose of the Study:

  • To evaluate the variability of the cardiac fat pad appearance on chest radiographs.
  • To determine if cardiomegaly or heart position can simulate a cardiac fat pad.

Main Methods:

  • Retrospective review of 50 chest computed tomographic (CT) scans.
  • Comparison of CT findings with concurrent chest radiographs (within 14 days).
  • Analysis of 16 patients with variable cardiac fat pad configurations and 4 patients with simulated findings.

Main Results:

  • A cardiac fat pad showed wide configuration variations in 32% of patients.
  • The fat pad could appear as increased density (well- or poorly-marginated) or reduced density.
  • Cardiomegaly or heart levoposition simulated a cardiac fat pad in 8% of patients by excluding lung from the vicinity.

Conclusions:

  • The cardiac fat pad has variable appearances on lateral chest radiographs.
  • Cardiomegaly and heart position are important differential diagnoses for a simulated cardiac fat pad.

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