Pericarditis

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Pericarditis is defined as inflammation of the pericardium. It is normally found in association with cardiac, thoracic or wider systemic pathology and it is unusual to manifest on its own.

Pathology

In general, infection is the most common cause of pericarditis. Infection accounts for two-thirds of cases while noninfectious causes account for the remaining one-third 9.

Pericarditis can be divided into subtypes according to morphology:

Acute forms
Established forms

Radiographic features

Plain radiograph

There may be an increased cardiothoracic ratio with a globular or 'flask shaped' outline if there is co-existing pericardial effusion.  Manifestations of cardiogenic pulmonary edema may also be present.

Ultrasound

Echocardiography may demonstrate pericardial effusion but can be normal in uncomplicated pericarditis.

CT

At contrast-enhanced CT, enhancement of the thickened pericardium generally indicates inflammation 1.

PET/CT

Focal FDG uptake may be demonstrated in some cases. 

MRI

Usually T1, T2, and GRE cine sequences are performed.  

The normal pericardial thickness is considered 2 mm while a thickness of over 4 mm suggests a pericarditis 1,2.  The presence of an arrhythmia may induce artefacts.

For specific features please refer to subtype articles. 

See also

  • -</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>There may be an increased <a href="/articles/cardiothoracic-ratio">cardiothoracic ratio</a> with a globular or 'flask shaped' outline if there is co-existing <a href="/articles/pericardial-effusion">pericardial effusion</a>.</p><h5>Ultrasound</h5><p>Echocardiography may demonstrate pericardial effusion but can be normal in uncomplicated pericarditis.</p><h5>CT</h5><p>At contrast-enhanced CT, enhancement of the thickened pericardium generally indicates inflammation <sup>1</sup>.</p><h5>PET/CT</h5><p>Focal FDG uptake may be demonstrated in some cases. </p><h5>MRI</h5><p>Usually T1, T2, and <a href="/articles/gradient-echo-sequences-1">GRE</a> cine sequences are performed.  </p><p>The normal pericardial thickness is considered 2 mm while a thickness of over 4 mm suggests a pericarditis <sup>1,2</sup>.  The presence of an arrhythmia may induce artefacts.</p><p>For specific features please refer to subtype articles. </p><h4>See also</h4><ul><li><a href="/articles/pericardial-effusion">pericardial effusion</a></li></ul>
  • +</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>There may be an increased <a href="/articles/cardiothoracic-ratio">cardiothoracic ratio</a> with a globular or 'flask shaped' outline if there is co-existing <a href="/articles/pericardial-effusion">pericardial effusion</a>.  Manifestations of cardiogenic <a title="Pulmonary edema" href="/articles/pulmonary-oedema">pulmonary edema</a> may also be present.</p><h5>Ultrasound</h5><p>Echocardiography may demonstrate pericardial effusion but can be normal in uncomplicated pericarditis.</p><h5>CT</h5><p>At contrast-enhanced CT, enhancement of the thickened pericardium generally indicates inflammation <sup>1</sup>.</p><h5>PET/CT</h5><p>Focal FDG uptake may be demonstrated in some cases. </p><h5>MRI</h5><p>Usually T1, T2, and <a href="/articles/gradient-echo-sequences-1">GRE</a> cine sequences are performed.  </p><p>The normal pericardial thickness is considered 2 mm while a thickness of over 4 mm suggests a pericarditis <sup>1,2</sup>.  The presence of an arrhythmia may induce artefacts.</p><p>For specific features please refer to subtype articles. </p><h4>See also</h4><ul><li><a href="/articles/pericardial-effusion">pericardial effusion</a></li></ul>

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