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Comparing Thin-Section and Thick-Section CT of Pericardial Sinuses and Recesses

Fumiko Kodama1,2, Patrick J. Fultz1 and John C. Wandtke1

1 Department of Radiology, University of Rochester Medical Center, 601 Elmwood Ave., Box 648, Rochester, NY 14642.
2 Present address: Department of Radiology, Faculty of Medicine Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan.



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  		Fig. 1. —Drawing shows posterior aspect of heart. Transverse sinus, mainly behind ascending aorta and pulmonary artery, is divided into anterior (1) and posterior (2) portions of superior aortic recess, inferior aortic recess (3), and left (4) and right (5) pulmonic recesses. Oblique sinus (6) lies posterior to left atrium. Pericardial sinus proper includes postcaval recess (7) and left (8) and right (9) pulmonary venous recesses. Note connections (arrows) between sinuses and recesses. Ao = aorta, SVC = superior vena cava, lPA = left pulmonary artery, rPA = right pulmonary artery, lPVs = left pulmonary veins, rPVs = right pulmonary veins, LA = left atrium, IVC = inferior vena cava.

 


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  		Fig. 2. —Drawing shows shapes of pericardial sinuses and recesses: line (1), band (2), spindle (3), crescent (4), point (5), hemisphere (6), ovoid (7), round (8), triangle (9), rhomboid (10), and irregular (11).

 


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  		Fig. 3A. —50-year-old woman with dyspnea. CT scan obtained with 2.5-mm collimation shows irregular-shaped right pulmonic recess (arrow) and spindle-shaped oblique sinus (arrowheads).

 


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  		Fig. 3B. —50-year-old woman with dyspnea. CT scan obtained with 5-mm collimation does not clearly show either of two sinuses seen on A.

 


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  		Fig. 4. —63-year-old woman with metastatic lung cancer. CT scan obtained with 3-mm collimation shows moderate volume of fluid (arrow) in triangular anterior portion of superior aortic recess. Note moderate volume of fluid (arrowhead) in hemispheric posterior portion of superior aortic recess.

 


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  		Fig. 5. —82-year-old woman with history of aortic aneurysm. CT scan obtained with 2.5-mm collimation shows small volume of fluid in linear inferior superior aortic recess (arrow) between ascending aorta and left atrium.

 


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  		Fig. 6. —48-year-old man with bilateral pleural effusions. CT scan obtained with 2.5-mm collimation shows linear left pulmonic recess (arrow) between right pulmonary artery and left superior pulmonary vein.

 


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  		Fig. 7. —70-year-old woman with chest pain. CT scan obtained with 2.5-mm collimation shows fluid (arrow) in band-shaped postcaval recess and moderate volume of fluid in irregular-shaped right pulmonic recess (arrowhead). Note small lymph node adjacent to oblique sinus (asterisk).

 


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  		Fig. 8. —48-year-old woman with malignant lymphoma. CT scan obtained with 3-mm collimation shows small volume of fluid (arrow) in hemispheric right pulmonary venous recess, which is projecting into lung parenchyma.

 


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  		Fig. 9. —65-year-old man with chronic heart failure. CT scan obtained with 2.5-mm collimation shows fluid in band-shaped left pulmonary venous recesses (arrow). Note lymph node (asterisk) adjacent to oblique sinus. E = esophagus.

 


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  		Fig. 10. —67-year-old woman with pleural effusion. CT scan obtained with 2.5-mm collimation shows crescentic anterior superior aortic recesses (asterisk) that mimics aortic dissection. Fluid attenuation was 21.1 H.

 


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  		Fig. 11. —50-year-old woman with bilateral lower lobe pulmonary embolism. CT scan obtained with 3-mm collimation shows fluid in round right pulmonary venous recess projecting into lung parenchyma, which mimics lower lobar lymph node (arrow). Fluid attenuation was 26.7 H.

 

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