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Panminerva Medica 2021 Feb 23

DOI: 10.23736/S0031-0808.21.04270-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Multimodality imaging in pericardial diseases

Michael CHETRIT 1, Martine PARENT 1, Allan L. KLEIN 2, 3

1 Department of Cardiovascular Medicine, McGill University, Montreal, Canada; 2 Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Cleveland Clinic, Cleveland, OH, USA; 3 Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA


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With a rapidly growing spectrum, non-specific symptoms and overlapping etiologies, pericardial diseases can represent a real diagnostic challenge. Consequently, multimodality imaging has taken a front seat in the diagnosis and management of these conditions. Cardiac CT offers an excellent anatomical characterization of pericardial thickening, fat stranding and/or presence of calcifications. and is also the preferred modality to assess extra-cardiac structures. Active pericardial inflammation, edema and fibrosis comprise pericardial characterization using CMR and allows for a precise diagnosis, disease staging and patient specific tailoring of therapies. PET scan still occupies a very modest role in the evaluation of pericardial diseases, but might help discriminating malignant pericardial effusion and extra-pulmonary tuberculous. More than ever, clinicians need to master how these modalities complement each other while avoiding unnecessary cost and to translate this knowledge into a more customized patient’s care approach. The aim of this review is to recognize the role of multimodality imaging in the investigation of various pericardial diseases, assess how these modalities can impact the clinical course and treatment of these affections and finally elucidate their role in the patient’s prognostication.


KEY WORDS: Acute pericarditis; Constrictive pericarditis; Tamponade; Effusive constrictive; Transient constrictive; Pericardial effusion

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