ABSTRACT
The normal pericardium is a thin, double-layered sac surrounding the heart and proximal central vessels (Figures 5.1 and 5.2). Together, the visceral/epicardial layer, the parietal layer, and the trivial physiologic amount of fluid have a normal thickness of about 1–2 mm. The two layers are lined by thin rims of visceral epi-/pericardial fat. Identification with imaging modalities is facilitated by these physiologic layers of epicardial and pericardial fat, which provide natural contrast. Echocardiography, MRI, and CT are all well established for the diagnosis of pericardial anatomy. Normal pericardium (64-slice scanner) https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429186318/82d84425-00cf-4291-bf75-b4e9afc9ca9b/content/fig5_1.jpg"/> The normal pericardium, which has a thickness of 1–2 mm, can be delineated over the left and right ventricles. By changing opacity in these volume-rendered images (VRIs), the heart is seen with (right panel) and without (left panel) the normal pericardium. The thin pericardial sac wraps the ventricles, the coronary arteries, and the root of the aorta. (Video 5.1) Normal pericardium https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429186318/82d84425-00cf-4291-bf75-b4e9afc9ca9b/content/fig5_2.jpg"/> Further manipulation of the volume-rendered images demonstrates the location of the pericardial sac wrapping the ventricles and the coronary arteries.
