The pericardium is a conical, flask-like, fibroserous sac which contains the heart and the roots of the great vessels and defines the middle mediastinum

The pericardium is made of two sacs in one. The outer sac is the fibrous pericardium and the inner sac is the double-layered serous pericardium. Layers of serous pericardium are divided by the pericardial space, which only contains 15-50 mL of serous fluid. Each layer has quite different structure and functions:

  • fibrous pericardium: tough connective tissue continuous with and bound to the central tendon of the diaphragm (pericardiophrenic ligament), the roots of the great vessels, the pretracheal layer of the deep cervical fascia and the sternum via the superior (to manubrium) and inferior sternopericardial ligaments (to xiphoid process)
  • serous pericardium: composed of a single layer of flattened mesothelial cells forming a closed sac and forms two continuous layers:
    • visceral serous pericardium (or epicardium): covers heart and great vessels
    • parietal serous pericardium: lines the fibrous pericardium and is inseparable

The serous pericardium is invaginated by the heart and great vessels forming two sinuses:

Adjacent to these sinuses, there may be one or several pericardial recesses:

  • tracheobronchial nodes
  • prepericardial nodes 9
  • pericardium appears as a thin high-density line between the lower-density mediastinal and epicardial fat
  • fibrous and serous pericardium cannot be delineated and the upper limits of normal for pericardial thickness is 2 mm 2
  • often not imaged over the left ventricle 3
  • T1 and T2: appears as a low signal rim between the higher-signal mediastinal and epicardial fat 2-3
Anatomy: Thoracic
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Article information

rID: 16559
System: Cardiac
Section: Anatomy
Synonyms or Alternate Spellings:
  • Pericardium anatomy

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