Hi Barry
- The points I want to try and get across
- How to diagnose constrictive pericarditis on CT
- Questions and Answers
-
- What are the signs of constrictive pericarditis on CT
- pericardial thickening
- diffuse or localized(2mm – 3mm equivocal)
- signs of impaired diastolic filling of the right ventricle
- ie signs of right heart failure including
- dilatation of the
- RA
- IVC and hepatic veins
- Coronary Sinus
- Azygos vein
- Hepatomegaly
- dilatation of the
- What is the role of the CXR and LA in Dx
- increase in left atrial because it cannot fill therefore
- increase in pulmonary venous pressure
- Usually normal size LA
- However since LA hmay be only partly covered by pericardium, it may in fact enlar
- pericardial thickening
- What are the signs of constrictive pericarditis on CT
-
- Questions and Answers
-
In our patient there is
- no pericardial thickening
- minor pericardial calcification
- There are
-
- focal adhesions near the LAD
-
Are There Signs of Constriction?
Consider
Pericardium Thickness
Size of the Right Atrium
? Size of the Coronary Sinus
? Size of the Azygos Vein and IVC
Thus constrictive pericarditis is not present
ABR
Links and References
Napolitano G et al Imaging Features of Constrictive Pericarditis: Beyond Pericardial Thickening Canadian Association of Radiologists Journal Volume 60, Issue 1, February 2009, (good review)
Senapati A et al, Disparity in spatial distribution of pericardial calcifications in constrictive pericarditis Openheart BMJmj. Volume 5, Issue 2
Khalid, N et al Pericardial Calcification StatPearls