PMC10237370_01
Panel A: MR of the abdomen showing a liver metastasis in the VII segment (arrowed) Panel B: MR of the abdomen showing a liver metastasis in the II segment (arrowed) Panel C: Steady-state free precession cine of a short axsis at mid-ventricular lever imaging showing the pericardial effusion Panel D,E: T1 weighted inversion recovery gradient echo image showing pericardial thickening (6 mm) and circonferential pericardial effusion. Panel F: Real time cine showing the initial shift of the interventricular septum (arrowed).
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The patient had a history of colorectal adenocarcinoma with liver metastases in segment II (Figure 1, Panel A) and segment VII, treated with percutaneous MWA (Figure 1, Panel B). A chest x-ray showed signs of pleural effusion and an enlarged, globular shaped heart shadow suggestive of increasing pericardial effusion (Figure 1, Panel D). A relapse of pericardial effusion measuring 3.4 cm with the presence of fibrin was noted in steady-state free precession cine imaging (Figure 1, Panel E). On phase-sensitive late gadolinium enhancement (LGE) images acquired 10 min after intravenous injection of 0.2 mmol/kg of a gadolinium-chelate contrast medium (Gadobutrol, Gadovist, Bayer Healthcare, Berlin, Germany), diffuse and marked enhancement of the pericardium was found (Figure 1, Panel F and G). The pericardium was thickened (6 mm) with early signs of ventricular interdependence in real-time cine imaging (Figure 1, Panel H), consistent with a pattern of initial constriction.