Postmortem computed tomographic (PMCT) findings of pericardial effusion due to acute aortic dissection

PURPOSE: To describe the appearance of pericardial effusion in deceased acute aortic dissection patients using postmortem computed tomography (PMCT). MATERIALS AND METHODS: PMCT examinations were performed within 2 hours of death in 30 patients with pericardial effusion due to aortic dissection who arrived at our hospital in a state of cardiopulmonary arrest. RESULTS: Pericardial effusion in 18 of 30 patients (60%) showed double concentric rings on PMCT with striking differences in density, a low-density outer ring along the pericardium and a high-density inner ring on the epicardial surface (hyperdense armored heart). Pericardial effusion in two patients (7%) showed a high-density fluid level (hypostasis). Pericardial effusion in the remaining 10 patients (33%) showed no such stratification. CONCLUSION: A "hyperdense armored heart" is the most frequently seen PMCT finding in deceased cases of pericardial effusion due to acute aortic dissection.