title: Accuracy of computed tomography findings in acute pericarditis.
abstract: BACKGROUND
  Acute pericarditis is a close clinical mimic of pulmonary embolism (PE) in the emergency department, and thus many of these patients are evaluated with chest computed tomography (CT).
  
  
  OBJECTIVE
  To study whether CT findings can be diagnostic of acute pericarditis.
  
  
  METHODS
  Using the electronic medical record, we retrospectively identified 46 cases of acute pericarditis and 46 control patients with pericardial effusions due to volume overload, all of whom underwent CT examination. Cases were reviewed by two blinded academic thoracic radiologists.
  
  
  RESULTS
  The majority, 67%, of the pericarditis cases were evaluated with PE-protocol CTs. Pericardial thickening/enhancement was the most accurate single parameter for pericarditis, with sensitivity of 54-59% and specificity of 91-96%.
  
  
  CONCLUSIONS
  CT findings, while not sensitive for pericarditis, are diagnostic, with few false-positives. Radiologists should be attentive to pericardial thickening or enhancement on CT studies done for chest pain, as they may be able to suggest pericarditis as an alternative diagnosis for the chest pain.
authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA hammerm@mir.wustl.edu.
authors: Mark M
authors: MM
authors: Hammer
authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA.
authors: Constantine A
authors: CA
authors: Raptis
authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA.
authors: Cylen
authors: C
authors: Javidan-Nejad
authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA.
authors: Sanjeev
authors: S
authors: Bhalla
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010493:Pericarditis / Q000150:complications / Q000000981:diagnostic imaging*; D010496:Pericardium / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids; D055815:Young Adult
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol
keywords: Acute pericarditis; chest pain; computed tomography; emergency radiology; pericardial enhancement