Pericardium

Dr Jeremy Jones et al.

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. They have quite different structures:

  • fibrous pericardium: tough connective tissue continuous with and bound to the central tendon of the diaphragm, the roots of the great vessels, the pretracheal layer of the deep cervical fascia and the sternum via the superior (to manubrium) and inferior sternopericardic 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:

Relations
Blood supply
Innervation
CT
  • 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
MRI
  • T1 and T2: appears as a low signal rim between the higher-signal mediastinal and epicardial fat 2-3

Thoracic anatomy
Share article

Article Information

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

Support Radiopaedia and see fewer ads

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.