CT and MRI for Assessment of Pericardial Disease: Systematic Review of Clinical Implications

Background: Clinical manifestations of pericardial disorders include constrictive pericarditis, effusion of the pericardium, and acute pericarditis. Later on, patients may experience recurrent or chronic pericarditis. Regarding the many pericardial illnesses, clinicians frequently encounter a number of diagnostic and treatment-related queries. Objectives: To evaluate the clinical implications of using computed tomography (CT) and cardiac magnetic resonance imaging (MRI) in the assessment of pericardial diseases. Methods: A comprehensive search of four databases led to the discovery of 611 relevant publications. After eliminating duplicates with Rayyan QCRI and assessing each article for relevance, 66 full-text articles were examined, and ultimately, 6 studies were selected based on the inclusion criteria. Results: We included six studies with a total of 250 patients with pericardial disease and 142 (56.8%) were males. Cardiac MRI was shown to be a valuable adjunct to standard diagnostic approaches, particularly in pediatric and recurrent pericarditis, by detecting pericardial inflammation even when traditional markers such as C-reactive protein were normal. Early MRI—performed within two weeks of symptom onset—improved diagnostic accuracy and helped identify patients at risk for complications or recurrence, supporting more targeted therapy. Additionally, 4D CT showed promise as an efficient tool for evaluating pericardial adhesions and aiding in preoperative planning. Conclusion: CT and MRI are essential components in the multimodal assessment of pericardial disease, providing critical information that influences both diagnosis and management. Although additional research is necessary to establish standardized protocols and evaluate long-term effects, the existing evidence encourages their wider adoption in clinical practice.