Differentiation of constrictive pericarditis from restrictive cardiomyopathy: The case for high-resolution dynamic tomographic imaging
The syndrome of constrictive pericarditis (CP) presents a diagnostic challenge to the clinician. This study was undertaken to determine whether cine computed tomography (CT), a cardiac imaging technique with excellent temporal and spatial resolution, can reliably demonstrate the unique abnormalities of pericardial anatomy and ventricular physiology present in patients with this condition. A second goal of this study was to determine whether the presence of diseased thickened pericardium, but itself, imparts cardiac impairment due to abnormalities of ventricular diastolic function. Twelve patients with CP suspected clinically, in whom invasive hemodynamic study was consistent with the diagnosis of CP, underwent cine CT. They were subdivided into Group 1 (CP, N = 5) and Group 2 (No CP, N = 7) based on histopathologic evaluation of tissue obtained at the time of surgery or autopsy. A third group consisted of asymptomatic patients with incidentally discovered thickened pericardium at the time of cine CT scanning: Group 3 (ThP, N = 7). Group 4 (Nl, N = 7) consisted of healthy volunteer subjects. Pericardial thickness measurements with cine CT clearly distinguished Group 1 (mean = 10 {+-} 2 mm) from Group 2 (mean = 2 {+-} 1 mm), with diagnostic accuracy of 100% compared to histopathological findings. In addition, patients in Group 1 had significantly more brisk early diastolic filling of both left and right ventricles than those in Group 2, which clearly distinguished all patients with and from all patients without CP. Patients in Group 3 had pericardial thicknesses similar to those in Group 1 (mean = 9 {+-} 1 mm, p = NS), but had patterns of diastolic ventricular filling that were nearly identical to Group 4 (NI).
- OSTI ID:
- 372501
- Report Number(s):
- CONF-9502135-; ISBN 0-8194-1781-5; TRN: 96:024179
- Resource Relation:
- Conference: SPIE medical imaging 1995 conference, San Diego, CA (United States), 27-28 Feb 1995; Other Information: PBD: 1995; Related Information: Is Part Of Medical imaging 1995: Physiology and function from multidimensional images; Hoffman, E.A. [ed.]; PB: 443 p.; Proceedings/SPIE, Volume 2433
- Country of Publication:
- United States
- Language:
- English
Similar Records
Computed tomography of the abnormal pericardium
Effect of mediastinal irradiation on cardiac function of patients treated during childhood and adolescence for Hodgkin's disease