The contemporary role of cardiac computed tomography and cardiac magnetic resonance imaging in the diagnosis and management of pericardial diseases

Pericardial syndromes encompass different clinical conditions from acute pericarditis to idiopathic chronic pericardial effusion. Transthoracic echocardiogram is the first and most important initial diagnostic imaging modality in most patients affected by pericardial disease. However, cardiac computed tomography and cardiac magnetic resonance (CMR) have recently gained a pivotal role in cardiology and recent reports supported the role of both these advanced techniques in the evaluation and guiding therapy of pericardial disease. The most promising tool is the capability of CMR to identify the presence of pericardial inflammation carrying both diagnostic and prognostic value in the setting of recurrent and chronic pericarditis. On the other side cardiac CT permits accurate evaluation of the presence and extension of pericardial calcification providing important information in confirming the diagnosis of constrictive pericarditis and during the preprocedural planning for patients undergoing pericardiectomy. Both cardiac CT and CMR correct indication and proper evaluation need specific expertise, especially for the evaluation of pericardial disease, thus the aim of the present review is to provide physicians an updated overview on the CCT and CMR role in pericardial disease focusing on technical issues, recent research findings and potential clinical applications.