AJR 2003; 181:1109-1113.
Truong MT, Erasmus JJ, Gladish GW, Sabloff BS, Marom EM, Madewell JE, Chasen MH, Munden RF.
The pericardium, consisting of a fibroserous sac that encloses the heart, is routinely imaged on CT [1-4]. Multidetector technology, in allowing rapid acquisition of volumetric data in high resolution and multiplanar reformation, has unproved anatomic imaging. Imaging with narrow collimation results in unproved delineation of cardiovascular anatomy and routine visualization of the pericardial recesses. The pericardial space normally contains a small amount of fluid (15-20 mL), and the fluid-filled recesses and sinuses can be misinterpreted as adenopathy or abnormality of an adjacent mediastinal structure. In oncologic imaging, staging and prognostic implications of fluid in a pericardial recess misinterpreted as adenopathy can significantly alter management and therapy. We review the anatomy of the pericardium with emphasis on the pericardial recesses that can potentially be misinterpreted as adenopathy.