Normal and Abnormal Pericardium: Radiologic Findings

The pericardium is a fibroserous sac formed by two layers that covers the heart. The pericardial space formed between these two layers contains a small amount of fluid (20–50 mL). Pericardial disease can be suspected by changes in the cardiomediastinal silhouette on chest radiographs, but the plain film features are nonspecific. Although echocardiography is the primary diagnostic technique in evaluating pericardial disease, especially pericardial effusion, CT and MRI are superior in several clinical settings; they should be preferred diagnostic tests for suspected pericardial thickening and masses. CT and MRI offer images with an excellent resolution and provide a good evaluation of the pericardial thickness, different types of pericardial effusions, and pericardial neoplasms. MRI affords the additional ability to scan in any plane, without the use of ionizing radiation or the need for contrast media.