Imaging of pericardial disease

Pericardial pathology is most often identified by its effect on cardiac function. Echocardiography is usually performed first in evaluation of pericardial disease, but is occasionally limited or indeterminate. MR imaging is often helpful in these cases, offering superior soft tissue contrast and the ability to image the entire pericardium and its relationship to cardiac structure and function. Many of the techniques recently developed for myocardial imaging are equally applicable to the pericardium and frequently assist in the diagnosis of pericardial disease. In this article, the authors review MR imaging techniques for pericardial imaging, discuss the appearance of the normal pericardium, and illustrate pathologic and congenital conditions of the pericardium.