Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Superior Recess of Pericardial Sinus
- Radiologic Findings
- Contrast-enhanced CT scan shows a curvilinear low density just right lateral to the ascending aorta and the right innominate artery. The density of it is about 5-10 HU. No pericardial effusion was noted (not seen) at the inferior sections.
- Brief Review
- The pericardium consists of an outer fibrous envelope and an inner serous sac, which is invaginated by the heart. The serous pericardium can be divided into a visceral layer, or epicardium, which covers the heart and great vessels, and a parietal layer, which lines the fibrous pericardium. The visceral pericardium is reflected from the heart, along the great vessels, and onto the parietal pericardium. At these reflections and between the great vessels, recesses or sinuses are formed within the pericardial space. These include the superior pericardial recess, transverse and oblique sinuses, the left pulmonic recess, the pulmonary venous recesses, and the recesses around the superior and inferior vena cavae.
Under physiologic conditions, pericardial cavity contains 20-25mL of serous fluid; however, the amount of fluid may vary considerably among individuals, particularly in children and infants. These differences may explain, at least in part, why in some patients, sinuses or recesses may or may not be seen.
The knowledge of their location and appearance was considered to be helpful to the radiologists in avoiding the misdiagnosis of lymphadenopathy and other mediastinal disease processes, such as thymic, tracheobronchial, and esophageal lesions.
- References
- 1. Levy-Ravetch M, Auh YH, Rubinstein WA, et al. CT of the pericardial recesses. AJR 1984;144:707-714.
2. Groell R, Schaffler GJ, Rienmueller R. Pericardial sinuses and recesses: findings at electrocardiographically triggered electron-beam CT. Radiology 1999;212:69-73.
3. Choe YH, Im J, Park JH, et al. The anatomy of the pericardial space: a study in cadavers and patients. AJR 1987;149:693-697.
- Keywords
- Pericardium, Congenital,