Sixteen-Slice Computed Tomography and Magnetic Resonance Imaging of Calcified Pericardium
A 48-year-old man with chest films suggesting pericardial calcifications was referred for cardiac MRI to assess diastolic function. The left ventricle (ejection fraction of 55%, end-diastolic volume of 127 mL, and stroke volume of 71 mL [MRI data, Siemens Symphony Maestro]) did not show any wall motion abnormalities. The diastolic filling pattern assessed with transmitral flow did not show signs of restriction. Pericardial calcifications were not apparent at the routine True-FISP cine sequence (Figure 1a). An additional T1-weighted FLASH gradient echo cine sequence showed some hints of pericardial calcifications (Figure 1b). Multislice CT (MSCT) scans were performed using the Mx8000 IDT 16-slice scanner (Philips Medical Inc). The contrast-enhanced scan revealed ectopic calcification of the parietal layer of the pericardial sac (Figure 1c). To assess the coronary tree with volume rendering, calcified tissue was defined with a center of 700 Houndsfield units (HU; window of 350 HU) and subtracted from the volume of interest (Figure 2). Figure 3 displays an unobstructed view at the left anterior descending artery. No significant coronary lesions were found.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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