CT provides limited and indirect hemodynamic information, such as enlargement of the atria and venae cavae in cases of pericardial constriction. Functional evaluation using CT is possible using retrospective ECG-gated examination, although the utility of such techniques are challenged by breath-held acquisition, suboptimal temporal resolution compared to echocardiography, and MRI as well as the potential increased artifact case of tachycardia or unstable heart rhythm [100,102]. Epicardial fat volume quantitation by CT has shown some association with the outcome of patients with a first episode of acute pericarditis and a potential prognostic implication [103], although this has limited clinical application to date. CTA Chest There is no relevant literature to support the use of CTA chest for the evaluation of dyspnea due to suspected pericardial disease, ischemia excluded. Although this procedure is not a first-line imaging test, it may provide information on pericardial changes such as effusion, thickening, or enhancement. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries for the evaluation of dyspnea due to suspected pericardial disease, ischemia excluded. FDG-PET/CT Heart There is limited literature regarding the use of FDG-PET/CT in the assessment of suspected pericardial disease, ischemia excluded. The presence of pericardial inflammation as stratified by standardized uptake values can predict reversibility of transient constrictive pericarditis with medical treatment. Using pericardial maximized standardized uptake value of 3.0 as a cutoff value, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT for predicting response to medical treatment were 100%, 71%, 82%, and 100%, respectively, in a small group (n = 16) of prospectively recruited patients with constrictive pericarditis [104].
Dyspnea Suspected Cardiac Origin Ischemia Already Excluded . CT provides limited and indirect hemodynamic information, such as enlargement of the atria and venae cavae in cases of pericardial constriction. Functional evaluation using CT is possible using retrospective ECG-gated examination, although the utility of such techniques are challenged by breath-held acquisition, suboptimal temporal resolution compared to echocardiography, and MRI as well as the potential increased artifact case of tachycardia or unstable heart rhythm [100,102]. Epicardial fat volume quantitation by CT has shown some association with the outcome of patients with a first episode of acute pericarditis and a potential prognostic implication [103], although this has limited clinical application to date. CTA Chest There is no relevant literature to support the use of CTA chest for the evaluation of dyspnea due to suspected pericardial disease, ischemia excluded. Although this procedure is not a first-line imaging test, it may provide information on pericardial changes such as effusion, thickening, or enhancement. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries for the evaluation of dyspnea due to suspected pericardial disease, ischemia excluded. FDG-PET/CT Heart There is limited literature regarding the use of FDG-PET/CT in the assessment of suspected pericardial disease, ischemia excluded. The presence of pericardial inflammation as stratified by standardized uptake values can predict reversibility of transient constrictive pericarditis with medical treatment. Using pericardial maximized standardized uptake value of 3.0 as a cutoff value, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT for predicting response to medical treatment were 100%, 71%, 82%, and 100%, respectively, in a small group (n = 16) of prospectively recruited patients with constrictive pericarditis [104].