Anatomic Pitfalls of the Heart and Pericardium

Anatomic Pitfalls of the Heart and Pericardium

Cardiac and Vascular

Lynn S. Broderick, MD ; Gregory N. Brooks, MD, PhD ; Janet E. Kuhlman, MD, MS

1 From the Department of Radiology, University of Wisconsin-Madison Medical School, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792. Presented as an education exhibit at the 2003 RSNA Scientific Assembly. Received April 14, 2004; revision requested June 8 and received August 3; accepted August 5. All authors have no financial relationships to disclose.

Recent technologic advances have led to more frequent dedicated cross-sectional imaging of the heart. Faster scanning techniques, cardiac gating, and advanced post processing software allow improved visualization of finer anatomic details of the heart and pericardium compared with older techniques and software. Use of thin-section computed tomography (CT) or image reformatting in nonaxial planes may be helpful in some cases. The cardiac and pericardial structures are usually readily demonstrated with CT, even if chest CT is performed for evaluation of noncardiac structures. However, radiologists are expected to evaluate all structures on an image, and incidental findings are common. Radiologists must first be familiar with the normal anatomic structures of the heart and pericardium (eg, atria, ventricles, cardiac valves, pericardial recesses, paracardiac structures) to avoid mistaking them for pathologic processes.