CT dimensions of the normal pericardium.

Abstract

Previous studies have suggested that the upper limit of the thinnest portion of the pericardium is 3-4 mm using 10 mm CT slices. However, these studies suffered from small sample sizes, long data acquisition times and unconventional viewing parameters. We have measured the width of the thinnest portion of the normal pericardium using 10 mm (100 patients) and 1 mm (100 patients) high resolution CT (HRCT) slices with modern CT equipment and fixed mediastinal window settings (400/20). The pericardium was identified in all patients and was best seen anterior to the heart. The pericardium is exceptionally well seen using 1 mm HRCT slices and this may be the optimal technique for visualization of the pericardium. The upper limit of the thinnest portion of the normal pericardium (mean value + 2 SD) was 1.2 mm (10 mm CT slices) and 0.7 mm (1 mm HRCT slices). These values are substantially lower than those previously reported and in line with anatomical findings.

Imaging the pericardium: appearances on ECG-gated 64-detector row cardiac computed tomography

“…The pericardial thickness varies over different parts of the heart; it is at its thinnest over the left ventricle. Bull et al, [4] reported that when using 1 mm high-resolution CT (HRCT) the upper limit of the thinnest part of the pericardium was 0.7 mm and when using 10 mm CT slices it was 1.2 mm. The upper limit of normal for the thickest part of the pericardium is 2 mm [5][6][7][8].…”

“…Echocardiography is highly sensitive and specific in detecting pericardial effusions, and indeed effusions may be easily seen on subcostal views obtained during conventional abdominal ultrasound examination. CT or MRI is indicated if the effusion is suspected to be complicated by haemorrhage (Figure 4), loculations, pericardial inflammation, thickening or constriction [4,14]. Accurate localisation of effusions can be facilitated and guide intervention and also allow further characterisation of the fluid.…”

CT Findings in Patients With Pericardial Effusion: Differentiation of Malignant and Benign Disease

“…Pericardial thickness was measured with electronic calipers after magnification of a region of interest at the most thickened area as visualized on the PACS monitor. On the basis of findings in previous studies [7,[12][13][14], we regarded a pericardial thickness greater than 3 mm as abnormal pericardial thickening.…”

Beyond the Coronary Arteries: Evolving Applications of Multi-detector Cardiac Computed Tomography in the Assessment of Non-coronary Structures

“…20 It is easily seen in both contrast-and non-contrast scans compared to the low attenuation of the surrounding fat. MDCT provides excellent delineation of pericardial anatomy of the entire chest, including the presence of any pericardial effusion, thickening or calcification.…”