Echocardiography
Cardiac CT
CMR
Echocardiography
Advantages
First line for diagnosis and follow-up
Widely available
Low cost
Safe and repeatable
Bedside (critically ill and pericardiocentesis)
Modalities
M-mode
2D echocardiography
Doppler
Tissue doppler velocities
Deformation Imaging
3D echocardiography
Contrast echocardiography
Twist and rotation
Limitations
Limited windows
Poor quality imaging
Operator dependent
Limited tissue characterization
Cardiac CT
Advantages
Better anatomic description
Evaluation of associated/extracardiac disease
Pre-operative planning
Detection of pericardial calcification
Modalities
Axial imaging
Multiplanar reconstruction
Volume renderer imaging
Cine-imaging
Limitations
Ionizing radiation
Iodinated contrast
Functional evaluation only possible with retrospective-gated studies
Difficult in case of arrhythmias
Need for breath-hold
Hemodynamically stable patients only
CMR
Advantages
Better anatomic description
Evaluation of associated/extracardiac disease
Pre-operative planning
Repeatable
Modalities
Bright blood-single-shot SSFP
Black blood images (+STIR)
Tagged cine-images
Bright blood cine-images
Late gadolinium enhancement images
Real time gradient-echo cine-images
Limitations
Time-consumming, high cost
Difficult in case of arrhythmias
Contraindicated with some devices (pacemakers, AICD...)
Calcifications not well visualized
Gadolinium not recommended if glomeral filtration rate <30mL/min)
Need for breth-hold
Hemodynamically stable patients only

SSFP = steady-state-free precession; STIR = short inversion time inversion-recovery.

Adapted from Verhaert D, et al.