Clinical Utility of Cardiac Magnetic Resonance Imaging in Pericardial Diseases

Aldweib, Nael; Farah, Victor; Biederman, Robert W

doi:10.2174/1573403x14666180619104515

Cited by 23 publications

(16 citation statements)

References 68 publications

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“…CMR has developed into an important tool for assessing severity and response to treatment in recurrent pericarditis. CMR findings of pericarditis include enhancement of the thickened pericardium on T1-weighted images and increased intensity of the pericardial tissue seen on T2-weighted images ( 5 ). Increased intensity upon gadolinium administration, a phenomenon referred to as DHE, is also seen ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…CMR findings of pericarditis include enhancement of the thickened pericardium on T1-weighted images and increased intensity of the pericardial tissue seen on T2-weighted images ( 5 ). Increased intensity upon gadolinium administration, a phenomenon referred to as DHE, is also seen ( 5 ). CMR findings of pericardial edema on DHE have a 99% specificity for the diagnosis of pericarditis ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the use of CMR is usually limited due to time, administration of contrast material, and financial cost. Therefore, CMR is done in complicated cases and in patients with persistent pleuritic chest pain with a high suspicion of pericarditis where an ECG and echocardiogram are nondiagnostic ( 5 , 6 ). This patient had positive CMR findings for pericardial edema (T2 STIR) and inflammation (DHE) on presentation representative of subacute pericarditis ( Figure 1A ).…”

Section: Discussionmentioning

confidence: 99%

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Inflamed Colon and Pericardium

et al. 2021

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A 29-year-old woman with severe ulcerative colitis presented with complicated recurrent pericarditis. Cardiac magnetic resonance imaging showed improvement in pericardial inflammation with a prolonged course of anti-inflammatory therapy, but she developed several relapses on biologics. Rilonacept (newer interleukin-1 antagonist), disease-modifying antirheumatic drugs, and pericardiectomy may be considered in such patients. ( Level of Difficulty: Intermediate. )

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inflamed Colon and Pericardium

et al. 2021

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“…9 Its roles are more limited in pericardial diseases, with one being when taken at the mitral and tricuspid inflows, the presence of >25% decrease and >40% increase in their velocities respectively during inspiration (and vice versa in expiration) support the presence of pericardial constriction or tamponade, similar to that observed in echocardiography. 2,23 T1 and T2 Mapping T1-and T2-mapping are emerging techniques in pericarditis evaluation, utilizing the exponential spin magnetization T1 relaxation and T2 decay properties of tissues after application of radiofrequency pulse. 7,25 The T1 relaxation and T2 decay times are the times for 63% (1-e -1) of the longitudinal magnetization to recover or transverse magnetization spin to go out of phase respectively, and these properties provide insights into the tissue being imaged.…”

Section: Radiofrequency Tissue Taggingmentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging Techniques and Applications for Pericardial Diseases

Wang

Ayoub

Chetrit

et al. 2022

Circ: Cardiovascular Imaging

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Cardiac magnetic resonance imaging plays a central role among multimodality imaging modalities in the assessment, diagnosis, and surveillance of pericardial diseases. Clinicians and imagers should have a foundational understanding of the utilities, advantages, and limitations of cardiac magnetic resonance imaging and how they integrate with other diagnostic tools involved in the evaluation and management of pericardial diseases. This review aims to outline the contemporary magnetic resonance imaging sequences used to evaluate the pericardium, followed by exploring the main clinical applications of magnetic resonance imaging for identifying pericardial inflammation, constriction, and effusion.

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“…TTE is used as first-line imaging technique in daily clinical practice and CT scan has an important role in detecting pericardial calcifications 2–4. For a comprehensive view and to estimate the extent of pericardial inflammation in terms of an accurate measurement of pericardial or surrounding structures, for example, myocardial involvement, CMR is increasingly used 5–7. Diagnosis of pericardial inflammation by CMR is usually made through the visualisation of thickened pericardium, pericardial oedema and contrast agent uptake 3 8.…”

Section: Introductionmentioning

confidence: 99%

Parametric mapping CMR for the measurement of inflammatory reactions of the pericardium

et al. 2022

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ObjectivesAlthough cardiovascular magnetic resonance (CMR) is increasingly used to diagnose pericardial inflammation, imaging can still be challenging using conventional CMR techniques. Parametric mapping (T1/T2 mapping) techniques have emerged as novel methods to quantify focal and global changes of the myocardium without contrast agent. The aim of the present study was to implement parametric mapping to facilitate diagnostic decision-making in pericardial inflammation.MethodsTwenty patients with pericardial inflammation underwent CMR (1.5T system) including T1-weighted/T2-weighted imaging, T1/T2 mapping and late gadolinium enhancement. T1/T2 mapping was performed in end-diastole covering three short-axis slices. Diagnosis of pericardial inflammation was made according to recent guidelines. T1/T2 measurements were pursued by manually drawing regions of interest (ROIs) in the thickened, diseased pericardium carefully avoiding contamination by other cardiac structures. Parametric values were correlated to further markers of pericardial inflammation, such as pericardial thickening and inflammatory parameters.ResultsOn average, the pericardium displayed a thickness of 4.8±1.0 mm. Mean T1 value was 1363.0±227.1 ms and T2 value was 123.3±52.6 ms, which were above patient’s myocardial values (myocardial T1: 998.7±81.0 ms, p<0.001, median 1014.46 ms; T2: 68.0±28.9 m,p<0.001) and the values of a group of four patients with chronic pericarditis (T1: 953.0±16.7 ms; T2: 63.2±10.1 ms). T1 and T2 showed a correlation to the extent of the thickened pericardium (R=0.64, p=0.002 for T1, R=0.72, p=0.005 for T2). There was no correlation of pericardial T1/T2 to blood markers of inflammation, myocardial injury (C reactive protein, troponin, creatine kinase) or further CMR parameters.ConclusionsIn patients with pericardial inflammation, parametric mapping showed elevated T1 and T2 values. Parametric mapping may help to facilitate diagnosis of pericardial inflammation if conventional parameters such as pericardial hyperintensity in T1-weighted or T2-weighted imaging or contrast agent uptake are heterogeneous.

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Clinical Utility of Cardiac Magnetic Resonance Imaging in Pericardial Diseases

Cited by 23 publications

References 68 publications

Inflamed Colon and Pericardium

Inflamed Colon and Pericardium

Cardiac Magnetic Resonance Imaging Techniques and Applications for Pericardial Diseases

Parametric mapping CMR for the measurement of inflammatory reactions of the pericardium

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