Pericarditis. Chest CT with i.v. contrast: Necrotic lymph nodes (blue arrow); pleural thickening with pleural effusion (orange arrow)
Pericarditis. Chest CT with i.v. contrast: Irregular pericardial thickening (blue arrow), and large pericardial effusion (orange arrow.
Pericarditis. Cardiac MRI: Axial cine images show large pleural effusion (orange arrow), mediastinal lymph nodes (green arrow), pericardial effusion with septa (blue arrow), and flattened right ventricle (purple arrow)
Pericarditis. Cardiac MRI: Sagittal cine images show large pleural effusion (orange arrow), pericardial effusion with septa (blue arrow), irregular thickening of the pericardium (green arrow), and flattening of the right ventricle (purple arrow)
Cardiac tuberculosis refers to the rare infection of the heart with Mycobacterium tuberculosis.
Generally associated with and occurring as a complication of mediastinal and pulmonary tuberculosis.
Pericardial and myocardial involvement is known. Endocardial spread may occur from myocardium. Modes of spread to the myocardium are via lymphatics from mediastinal nodes, directly from the pericardium, or via a haematogenous route.
- acute stage: no findings in heart, but active lung infection may be present
- chronic stage: pericardial calcification
- pericardial effusion (mild)
- pericardial thickening
- pericardial calcification (chronic stage)
- T1: nodular lesion which appears isointense to slightly hyperintense
- T2: isointense
- C+ Gd: mild heterogeneous enhancement
Treatment and prognosis
Patients generally respond well to antituberculous therapy. Clinical examination, known primary pulmonary infection and follow-up examinations will help confirm the diagnosis.
Imaging differential considerations include: