Pericardial effusion

Rebecca Lindell, Thomas Hartman

Research output: Chapter in Book/Report/Conference proceedingChapter


Imaging description Pericardial effusion is caused by the obstruction of the lymphatic or venous drainage from the heart [1]. Accumulation of pericardial fluid above 50 ml is abnormal, which corresponds to 4 mm thickness of the pericardium on cross-sectional imaging [2, 3] (Figure 63.1). Simple effusions tend to have the attenuation of water on CT (<10 HU) (Figures 63.2 and 63.3), while exudative (20–60 HU) or hemorrhagic (60–80 HU) effusions have attenuation values greater than that of water [2, 4]. Pericardial effusions accompanied by pericardial thickening are suggestive of inflammatory pericarditis [4]. MRI can be helpful in characterizing pericardial effusions [3–5] (Figure 63.4). Signal characteristics may help distinguish pericardial fluid from thickening or may distinguish between simple and exudative or hemorrhagic transudative effusions. Simple effusions have no or very little T1-weighted signal intensity, while exudative or hemorrhagic effusions often are medium or high signal intensity on T1 sequences [3–5]. Importance Pericardial effusions are often asymptomatic but large effusions may be symptomatic and, therefore, are important to identify in order to alert the clinician. Occasionally the cause of a pericardial effusion can be identified on cross-sectional imaging, especially in cases of hemopericardium.

Original languageEnglish (US)
Title of host publicationPearls and Pitfalls in Thoracic Imaging
Subtitle of host publicationVariants and Other Difficult Diagnoses
PublisherCambridge University Press
Number of pages2
ISBN (Electronic)9780511977701
ISBN (Print)9780521119078
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Medicine(all)


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