Role of tissue characterization by Cardiac Magnetic Resonance in the diagnosis of constrictive pericarditis

Giovanni Donato Aquaro, Andrea Barison, Alessandro Cagnolo, Giancarlo Todiere, Massimo Lombardi, Michele Emdin

Research output: Contribution to journalArticlepeer-review

Abstract

Cardiac Magnetic Resonance (CMR) allows evaluation of the functional and flow changes in pericardial constriction as well as detection of acute pericardial inflammation, fusion and thickening of pericardial layers and pericardial effusion. We sought to evaluate the diagnostic role of tissue characterization by CMR in constrictive pericarditis (CP). We performed a CMR exam in 70 patients (mean age 58 ± 16) with clinical suspicion of constrictive pericarditis and constrictive pattern at echocardiography and/or catheterization. A multiparametric CMR approach was used to evaluate the initial diagnostic suspicion. A clinical follow-up was performed in all patients for a median of 551 days. The diagnosis of CP was confirmed in 53 patients while 12 patients presented signs of predominant pericardial active inflammation suggesting a diagnosis of transient constrictive pericarditis and five presented effusive-constrictive pericarditis. Patients with a final diagnosis of CP had worse prognosis than those with transient constrictive or effusive constrictive pericarditis. The presence of myocardial late gadolinium enhancement was associated to adverse events. Results of the current study confirmed the value of CMR in the differential diagnosis of pericardial disease. A multiparametric CMR approach allowed to distinguish between active inflammation, chronic pericarditis with constriction and effusion without inflammation.

Original languageEnglish
Pages (from-to)1021-1031
Number of pages11
JournalInternational Journal of Cardiovascular Imaging
Volume31
Issue number5
DOIs
Publication statusPublished - Jun 29 2015

Keywords

  • Acute pericarditis
  • Cardiac Magnetic Resonance
  • Constrictive pericarditis
  • Pericardial effusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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