2086 Delayed enhancement of pericardium in suspected constrictive pericarditis
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Meeting abstract
2086 Delayed enhancement of pericardium in suspected constrictive pericarditis Byoung Wook Choi*, Young-Jin Kim, Jin Hur, Kyu Ok Choe and Namsik Chung Address: Yonsei University College of Medicine, Seoul, Republic of Korea * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A355
doi:10.1186/1532-429X-10-S1-A355
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A355 © 2008 Choi et al; licensee BioMed Central Ltd.
Introduction Enhancement of the thickened pericardium after the administration of gadolinium-based contrast material suggests inflammation. However the prevalence and characteristics of pericardial enhancement related to other findings are not clear in constrictive pericarditis.
Purpose We aimed to determine prevalence and characteristics of pericardial enhancement in constrictive pericarditis with delayed enhancement CMR
Methods A total of 18 patients, who were suspected to have constrictive pericarditis by clinical manifestation and echocardiographic examination, were enrolled in this study. All patients underwent CMR. CMR protocol included T1-weighted short-axis imaging at mid-ventricle, T2-weighted short-axis imaging at mid-ventricle, cine imaging with SSFP sequence (2-chamber view, 4-chamber view, short axis view encompassing entire heart with 10 mm thickness without gap), delayed enhancement CMR with same planes as the cine planes 10 minutes after administration of 0.2 mmol/kg gadolinium-based contrast agent. Look-locker sequence was used to determine the inversion time for nulling myocardial signal. To diagnose constrictive pericarditis, considered positive was pericardial thickeness ≥ 4 mm, septal bouncing motion, small ventricle, pericardial adhesion to ventricle in cine imaging, atrial enlargement, systemic venous dilatation.
We analyzed pericardial enhancement related to other findings.
Results There were 11 men and 7 women patients. Age ranged from 14 to 72 years (mean ± SD: 54.8 ± 15.2 years). Fourteen patients (78%) had diagnosis of constrictive pericarditis in CMR. Pericardial thickening ≥ 4 mm were in 8 patients of them (57%). Pericardial enhancement was detected in 6 patients with pericardial thickening (6/8, 75%). There was no enhancement in the pericardium without thickening. Seven patients had pericardial effusion but only 3 of them (43%) showed pericardial enhancement. Enhancement of parietal and visceral pericardium could be distinguished only when pericardial effusion existed. Enhancement or high-signal intensity due to inhomogenous fat suppression in pericaridial or epicardial fat layer was frequent and should be carefully interpreted.
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