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Pericardial Disease

Vivian S. Lee¹

¹New York University Medical Center, New York, New York

Publication Name:

Current Protocols in Magnetic Resonance Imaging

Unit Number:

Unit A11.1

DOI:

10.1002/0471142719.mia1101s00

Online Posting Date:

May, 2001

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Abstract

This unit presents a basic technique for evaluating non-neoplastic disease of the pericardium with optional contrast-enhanced sequences for evaluating suspected neoplastic disease. The parameters are based on experience on a Siemens 1.5 T Vision or Symphony and should be altered accordingly for different field strengths and machines from different manufacturers.

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Unit Introduction
Basic Protocol: Imaging of Nonneoplastic Pericardium
Alternate Protocol: Imaging of Neoplastic Pericardium
Commentary
Bibliography
Figures
Tables

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Materials

Alternate Protocol: Imaging of Neoplastic Pericardium

Materials

Normal saline (0.9% NaCl), sterile
Gadolinium-based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance)

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Figures

Figure A11.1.1

Normal pericardium. (A, B) Transverse HASTE images at two levels demonstrating normal low signal intensity line measuring <4 mm, corresponding to normal pericardium (arrows).

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Figure A11.1.2

Constrictive pericarditis. (A) Transverse HASTE and (B) transverse cine gradient-echo image show thickening of the pericardium (arrowheads), enlargement of the atria, and associated compression of the right ventricle (RV).

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Figure A11.1.3

Pericardial cyst. (A) Transverse and (B) coronal HASTE images show a well-defined oval mass (arrows) with high signal intensity on T₂-weighted images in the right cardiophrenic angle, a characteristic location for a pericardial cyst. Contrast-enhanced images (not shown) confirmed a lack of enhancement in this lesion.

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Figure A11.1.4

Pericardial and cardiac lymphoma. (A) Transverse HASTE image and (B) coronal cine gradient-echo image of the heart demonstrate a large mass (arrows) that invades through the pericardial space into the right heart in a patient with lymphoma.

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Literature Cited

Literature Cited
	Barakos, J.A., Brown, J.J., and Higgins, C.B. 1989. MR imaging of secondary cardiac and paracardiac lesions. Am. J. Roentgenol. 153:47-50.
	Hancock, E.W. 1990. Neoplastic pericardial disease. Cardiol. Clin. 8:673-682.
	Martin, E.T., Fuisz, A.R., and Pohost, G.M. 1998. Imaging cardiac structure and pump function. Cardiol. Clin. 16:135-160.
	Masui, T., Finck, S., and Higgins, C.B. 1992. Constrictive pericarditis and restrictive cardiomyopathy: Evaluation with MR imaging. Radiology 182:369-373.
Key References
	Dupuis, K., Thangaraj, V., and Edelman, R.R. 1996. Practical MRI for the technologist and imaging specialist. In Clinical Magnetic Resonance Imaging (R.R. Edelman, J.R. Hesselink, and M.B. Zlatkin, eds.) pp. 52-87. W.B. Saunders, Philadelphia.
Covers a wide range of practical information for setting patients up for MRI and also includes a useful description of cardiac imaging sequence parameters.
	Higgins, C.B. 1992. Essentials of Cardiac Radiology and Imaging. J.B. Lippincott, New York.
Contains a detailed description of the spectrum of modalities that can be used to image the pericardium, including plain film radiography and MRI.
	White, C.S. 1996. MR evaluation of the pericardium and cardiac malignancies. MRI Clin. North Am. 4:237-251.
Reviews the anatomy and pathology of the pericardium with an emphasis on MRI findings.