- Cardiac Tamponade: Causes
- Malignant pericardial effusion
- Free wall aortic rupture following a myocardial infarction
- Rupture of a coronary artery aneurysm
- Complications of endocarditis
- Cardiac neoplasms
- Dressler syndrome
- Trauma - Cardiac Tamponade: Causes
- Aortic dissection
- Aneurysm rupture
- Lung cancer
- Esophageal cancer - Cardiac Tamponade: CT Findings
- Enlargement of the SVC with a diameter similar to or greater than that of the adjacent thoracic aorta
- Enlargement of the IVC with a diameter or greater than twice that of adjacent abdominal aorta
- Periportal lymphedema
- Reflux of contrast material within the IVC
- Reflux of contrast material within the azygous vein
- Enlargement of hepatic and renal veins - “ Cardiac tamponade is a hemodynamic state that results from the slow or rapid accumulation of fluid, pus, blood, gas, or benign or malignant neoplastic tissue within the pericardial cavity.”
Imaging Findings in Cardiac Tamponade with Emphasis on CT
Restrepo CS et al.
RadioGraphics 2007; 27:1595-1610
- Pericardial Cyst: Facts
- More common in right cardiophrenic space (77%)
- Congenital in origin
- Always asymptomatic
- Attenuation usually 0-20 HU
- No enhancement on contrast enhanced studies - Primary Pericardial Metastases: Differential Dx
- Benign tumors like teratoma, lipoma, lymphangioma, neurofibroma
- Malignant tumors like mesothelioma, angiosarcoma, lymphoma and hemangioendothelioma - Metastases to the Pericardium: Causes
- Lung cancer (number one at 36%)
- Lymphoma
- Leukemia
- Breast cancer
- Esophageal cancer
- Melanoma
- Renal cell carcinoma - Pericardial Calcification: Causes
- Chronic purulent pericarditis
- TB
- Rheumatic fever
- Hemopericardium
- Prior trauma
- Radiation therapy - Cardiac Tamponade: CT Findings
- Large pericardial effusion
- Enlargement of either the SVC (diameter similar or greater than adjacent aorta) or IVC (diameter twice adjacent aorta)
- Periportal edema
- Reflux of contrast into IVC and azygous vein or enlargement of hepatic and renal veins - Normal Pericardium: Facts
- < 2 mm thick
- Contains 15-50 ml of fluid
- Pericardial recesses can be confused with adenopathy or other masses "CT is a powerful diagnostic tool for evaluating the pericardium and its abnormalities. Knowledge of the normal recesses and sinuses is essential to avoid misdiagnosis. Functional imaging is useful in the evaluation of pricardial constriction and tamponade." Computed Tomography of the Pericardium and Pericardial Disease
Rajiah P et al.
J Cardiovasc Comput Tomogr (2010) 4,3-18 - Pericardial Cyst: Facts
- Usually at right anterior costophrenic angle
- Water density on CT
- 2-3 c in size
- Homogeneous without any enhancement - Pericardial Cyst: Facts
- Usually an incidental finding
- May be confused with a Morgagni hernia or duplication cyst or occassionally a thymic cyst - Pericardial Cyst: Differential Diagnosis
- Loculated pleural effusion
- Bronchogenic cyst
- Hematoma
- Esophageal duplication cyst
- Pericardial tumor
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