Pericardial Recesses on Computed Tomography: Implications for the Pulmonologist

Area of Science:

• Radiology
• Cardiovascular Imaging
• Thoracic Anatomy

Background:

• The pericardium, a double-walled sac, encloses the heart and features serosal reflections forming sinuses and recesses.
• Advancements in multidetector computed tomography (CT) technology allow for frequent detection of these pericardial recesses.

Purpose of the Study:

• To provide a comprehensive review of pericardial anatomy and its variations as visualized on CT.
• To highlight potential pitfalls in interpreting pericardial structures on CT imaging.
• To discuss the clinical implications for pulmonologists, focusing on avoiding misinterpretations and unnecessary interventions.

Main Methods:

• Review of thin-section multidetector computed tomography (CT) scans.
• Detailed analysis of pericardial anatomy, including sinuses and recesses.
• Identification and discussion of common interpretation errors and their consequences.

Main Results:

• Pericardial recesses are commonly identified with modern thin-section CT.
• Misinterpretation of these recesses can lead to confusion with conditions like adenopathy, metastasis, or aortic dissection.
• Understanding normal pericardial anatomy is key to accurate diagnosis.

Conclusions:

• Accurate knowledge of pericardial anatomy on CT is crucial for correct diagnosis.
• Avoiding misinterpretation of pericardial recesses prevents unnecessary patient management and interventions.
• This review aids pulmonologists in the precise interpretation of thoracic CT scans.