hämorrhagischer Perikarderguss
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Coronal reconstructed image from preliminary unenhanced acquisition revealed hyperattenuating (55 Hounsfield units) pericardial effusion (+) consistent with hemopericardium.
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Arterial-phase enhanced acquisition with bolus tracking technique showed contrast medium (*) extravasation through a full-thickness breach (Arrow) of the lateral wall of the left ventricle. Note hemopericardium(+), intra-aortic balloon pump(arrowhead).
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.Note hemopericardium (+).
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Coronal (C), sagittal (D), oblique (E) and 3D volume-rendering reconstruction (F) confirmed contrast (*) extravasation through a full-thickness discontinuity (arrow) of the left ventricular myocardium consistent with complete myocardial rupture.Note hemopericardium (+).
Post-infarction
full-thickness myocardial rupture: a life-saving CT diagnosis. Additional venous phase acquisition showed increased opacification of the pericardial effusion (*) by contrast extravasation through the full-thickness rupture of the left ventricular myocardium (Arrow). Note hemopericardium (+).
Significant
incidental cardiac disease on thoracic CT: what the general radiologist needs to know. Non-contrast axial image from a dedicated aortic CT through the lower chest, showing hemopericardium in a 43-year-old male who being evaluated for congestive heart failure and low ejection fraction, following aortic valve surgery
Hemopericardium
• Aortic dissection with rupture into the pericardial sac - Ganzer Fall bei Radiopaedia
Hemopericardium
• Aortic dissection with rupture into pericardium - Ganzer Fall bei Radiopaedia
Left
ventricular pseudoaneurysm • Left ventricular pseudoaneurysm - Ganzer Fall bei Radiopaedia
Hemopericardium
• Hemopericardium - Ganzer Fall bei Radiopaedia
Pericardial
effusion • Oreo cookie sign of pericardial effusion - Ganzer Fall bei Radiopaedia
Hemopericardium
• Hemopericardium from pacemaker wire perforation of right atrium - Ganzer Fall bei Radiopaedia
Hemopericardium refers to the presence of blood within the pericardial cavity, i.e. a sanguineous pericardial effusion. If enough blood enters the pericardial cavity, then a potentially fatal cardiac tamponade can occur.
Pathology
Etiology
There is a very long list of causes but some of the more common are:
- ruptured myocardial infarction
- ruptured left ventricular aneurysm
- aortic dissection
- pericarditis
- trauma
- blunt/penetrating/deceleration
- iatrogenic, e.g. pacemaker wire insertion
- cardiac malignancies
- ruptured coronary artery aneurysm
- post-thrombolysis
Radiographic features
Plain radiograph
- enlargement of the cardiac silhouette may be present but chest x-rays are insensitive and non-specific
- the "straight left heart border" is an infrequent sign with low sensitivity (~40%) for hemopericardium in penetrating trauma patients
- the Oreo cookie sign on lateral CXR
CT
- pericardial effusion with a density >35 HU or that of water
Differential diagnosis
- vicarious contrast material excretion into the pericardium post cardiac catheterization may mimic hemopericardium on CT
Siehe auch:
- Perikarderguss
- Perikarditis
- eitrige Perikarditis
- Perikarddrainage
- Herzbeuteltamponade
- Perforation Schrittmachersonde
- Myokardruptur
und weiter:
Assoziationen und Differentialdiagnosen zu hämorrhagischer Perikarderguss:
