Anatomy of pericardial recesses on multidetector CT: implications for oncologic imaging.

Abstract

1109 he pericardium, consisting of a fibroserous sac that encloses the heart, is routinely imaged on CT [1–4]. Multidetector technology, in allowing rapid acquisition of volumetric data in high resolution and multiplanar reformation, has improved anatomic imaging. Imaging with narrow collimation results in improved delineation of cardiovascular anatomy and routine visualization of the pericardial recesses. The pericardial space normally contains a small amount of fluid (15–20 mL), and the fluidfilled recesses and sinuses can be misinterpreted as adenopathy or abnormality of an adjacent mediastinal structure. In oncologic imaging, staging and prognostic implications of fluid in a pericardial recess misinterpreted as adenopathy can significantly alter management and therapy. We review the anatomy of the pericardium with emphasis on the pericardial recesses that can potentially be misinterpreted as adenopathy.