Right Ventricular Diastolic Collapse by Cardiac Magnetic Resonance Imaging

Abstract

Although the detection of pericardial effusion is relatively easy with 2-dimensional (2-D) echocardiography, the noninvasive physiological assessment of pericardial tamponade is more difficult. Pericardial tamponade is best assessed by simultaneous measurement of right atrial or ventricular pressure and intrapericardial pressure. In order to justify invasive pericardiocentesis, noninvasive data are usually acquired before pursuing a potentially risky invasive procedure. One of the earliest signs of tamponade is diastolic collapse of the right ventricle (RV), usually in early diastole, indicating that intrapericardial pressure is transiently exceeding RV filling pressure during diastole. This finding on 2-D echocardiography has been correlated with a decrease in cardiac output and impending tamponade.1–3 However, complete visualization of the RV free wall is frequently difficult with 2-D echocardiography because of the limitations of the intercostal echo “window.” Imaging of RV free-wall motion can be accomplished in true anatomic planes with cardiac magnetic resonance imaging (MRI) in multiple projections with relative ease, enhancing the ability of this technique to detect abnormalities of RV …