Table 1 Advantages and disadvantages of multi-modality imaging in pericardial disease evaluation [3,4,5]
From: Multiple pericardial hematomas: a case report and mini-review in multimodality imaging
Modalities | Advantages | Disadvantages |
|---|---|---|
Echocardiography | Easily performed (bedside and in emergency setting) Identification of: Pericardial effusion Intrapericardial clot Hemodynamic assessment for: Tamponade Constrictive physiology | Limitation for window: Narrow field of view Poor window in obesity, Chronic obstructive pulmonary disease (COPD), or patient with mechanical ventilation Limited in the assessment of: Pericardial thickness Tissue characterization |
CT Scan | Identification of: Pericardial thickening Pericardial effusion Pericardial mass (cysts, thrombus/hematoma) Pericardial calcification Evaluation of associated intrathoracic abnormalities, such as: Pleural abnormalities (thickening, effusion) Pulmonary abnormalities (masses or other lesions) Lymph node involvement | Risks associated with radiation and contrast Unsuitable in critically-ill or uncooperative patients Limitation in: Evaluation of the elasticity of the pericardium Hemodynamic assessment, especially in assessing constrictive and tamponade physiology Differentiation of hemorrhagic effusions with thrombus/ hematoma (similar Hounsfield unit attenuation) |
CMRI | A more detailed evaluation of pericardial anatomy Assessment of pericardial thickness Identification and characterizations of Pericardial fluid Pericardial masses | High cost, time-consuming Unsuitable in critically-ill or uncooperative patients Limited use in: Metal prosthetic; ICD or pacemaker-implanted patient End-stage renal disease: related to contrast Poor-quality for calcification evaluation |
Nuclear imaging | Hybrid: Anatomic and metabolic evaluation Identification and detection of: Neoplasm: FDG/PET Infection/Inflammation | High cost, high maintenance Risk of radiation No data on pericardial hematoma and cyst |