Epicardial Involvement of Constrictive Pericarditis Can Be Detected by Magnetic Resonance Imaging

Constrictive pericarditis is a surgical disease that requires removal of the pericardium. In cases in which the disease process involves the epicardium, removing the pericardium may not adequately treat the constrictive process. Current imaging techniques are limited in their ability to preoperatively determine epicardial involvement. Cardiac magnetic resonance imaging with late gadolinium enhancement of the pericardium is useful in conjunction with echocardiography to define extent of disease, pericardial compliance, and hemodynamics. We propose the use of cardiac magnetic resonance imaging, and specifically late gadolinium enhancement extending into the epicardium, as a marker of epicardial involvement based on our initial experience.