What is the role of MRI in the workup of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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MRI can detect as little as 30 mL of pericardial fluid. It may be able to distinguish hemorrhagic and nonhemorrhagic fluids, as hemorrhagic fluids have a high signal intensity on T-1 weighted images, whereas nonhemorrhagic fluids have a low signal intensity. Nodularity or irregularity of the pericardium seen on MRI may be indicative of a malignant effusion.

MRI is more difficult to perform acutely than CT scanning is, given the length of time the patient must remain in the scanner.

Late gadolinium enhancement can reveal areas of inflammation, which can potentially help decide about anti-inflammatory therapy in recurrent pericarditis and can also aid in the diagnosis of effusive-constrictive pericarditis. [25]

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