Constrictive pericarditis. A 67-year-old male with seropositive rheumatoid arthritis. An echocardiogram (images not available) was performed showing pericardial thickening and a small effusion. Paired images a, b, and c represent static images from dynamic MR imaging sequences. Cine tagged MR imaging: Transient fiducial grid-patterned image markers on sagittal images (a) demonstrates failure to dephase after several seconds, indicating nonslippage. Had the pericardium moved with respect to myocardium, the tag lines would have been broken. Instead they deformed only slightly, indicative of pericardial adhesion and providing evidence for constriction. (b, c) Breath-held SSFP long and short axis images demonstrate “septal bounce.” (d) The inferior vena cava is distended at 3.1 cm, providing corroborating evidence for elevated right heart pressures [30].
