Dados do Trabalho

Título

Total eclipse of the heart: turning around the pericardium

Introdução e objetivo(s)

As imaging resolution has improved, the pericardium, with its sinuses and recesses, can be identified as defined anatomical structures in a larger amount of scans, even if some images are performed for evaluation of noncardiac structures. This educational exhibit aims to review usual and unusual cases related to the pericardial sinuses and recesses, correlating important findings with the anatomy, embryology and pathophysiology, focusing on their clinical-radiological correlations.

Método(s)

Literature review and retrospective analysis of cases related to the pericardial sinuses and recesses, obtained through CT and MR, , sometimes complemented by other imaging methods, of experience and/or authors' own files. The imaging characteristics will be demonstrated by means of anatomical sections, multiplanar reconstructions, volumetric acquisition and simplified pictorial schemes.

Discussão

The pericardium, consisting of a fibroserous sac that encloses the heart, is routinely imaged on radiologists’ daily practice, consisted of two main components, fibrous and serous pericardium, the later with two layers (epicardium or visceral pericardium and parietal pericardium). Linked to the epipericardial fat and cardiac surface, the pericardium is easily recognizable during image acquisition as a linear image, while the sinus and recesses are structures of low attenuation near water, formed by extensions of the pericardial cavity when the visceral layer adapts to the entry of vessels into the heart or between them. Despite its imaging characteristics delineating the cardiovascular anatomy, pericardial sinus and recesses must be promptly distinguished from pathologic process, as mediastinal lymphadenopathy, thrombus, mediastinal cystic masses and other lesions, avoiding unfavorable patient outcomes.

Conclusões

In the radiological study, mainly of oncological patients, it is crucial the radiologist's knowledge about the pericardial sinuses and recesses, their imaging aspects of the normal anatomy and anatomical variations, to avoid misunderstandings that could lead to diagnostic and therapeutic errors, resulting in unfavorable outcomes.

Palavras Chave

pericardium; recesses; sinus.

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