Protocol
  1. Anatomy module (A) including T1w and T2w
  2. LV function module (B)
  3. RV function module (C)
  4. RV function module (C) (axial and RVOT)
  5. Real-time dynamic respiratory cine
  6. LGE module (E)
Report
  1. Dimensions (corrected for BSA) and function
    • LV: EDV, ESV, SV, EF
    • RV: EDV, ESV, SV, EF
  2. Septal motion during normal and dynamic respiration
  3. Pericardial thickening ≥3mm
  4. Presence or absence of RV diastolic collapse
  5. LGE enhancement in RV, LV and pericardium
Key Points
  1. Pericardial thickening, calcification, scarring with preserved LV function, but impaired diastolic filling
  2. Constrictive pericarditis is usually a chronic disease, but consider transient constriction in inflammation states
  3. Typical findings:
    • Septal shift towards LV during inspiration
    • Dilated atria
    • Definitive diagnosis requires additional studies
  4. Constriction can be localized but often leads to an impairment of biventricular filling
  5. Common causes: post cardiac surgery / trauma, irradiation, inflammation, connective tissue disease, idiopathic
Tips and Tricks
  1. Pericardial constriction may be present even with a normal pericardial thickness or patchy thickening
  2. Real-time dynamic respiratory sequence in several SA views and in a 4-ch view (paradoxical septal motion is often being limited to one part of the septum)
  3. CMR cannot conclusively detect calcification
References
  1. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. ESC Clinical Practice Guidelines 2015