Constrictive pericarditis CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

CT

Pericardial thickening may result in constrictive pericarditis. In this entity, pericardial thickening will hamper cardiac function, with hemodynamic consequences. Many disease conditions can lead to constrictive pericarditis (infection, tumor, radiation, heart surgery, etc.).

The diagnostic features include thickened pericardium in conjunction with signs of impaired right ventricular function: dilatation of caval veins and hepatic veins, enlargement of the right atrium, and the right ventricle itself may be normal or even reduced (tubular, sigmoid) in size due to compression. Localized pericardial thickening may also cause functional impairment (localized constrictive pericarditis). Sometimes constriction may occur despite a normal appearance of the pericardium.

Pericardial calcifications and pericardial thickness are easily visualized by CT but may be difficult or impossible to appreciate on MRI. This condition would be diagnosed as restrictive cardiomyopathy if the pericardium thickness is more than 4 mm.

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