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Shin, Kim, Han, Huh, Kim, and Kim: Quantification of Large Pericardial Effusion by Two-Dimensional Echocardiography
Original Article

J Korean Soc Echocardiogr 1995;3(2):196-203.

Published online: 18 February 1995

DOI: https://doi.org/10.3803/jkes.1995.3.2.196

Quantification of Large Pericardial Effusion by Two-Dimensional Echocardiography

Kyeung Mok Shin, M.D., Kee Sik Kim, M.D., Seung Wook Han, M.D., Seoun Ho Huh, M.D., Yoon Nyun Kim, M.D., Kweon Bae Kim, M.D.

Department of Internal Medicine, School of Medicine, Keimyung University, Taegu, Korea

Copyright © 1995 Korean Society of Echocardiography

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The accurate information about the volume of pericardial effusion can assist in clinical decisions and has important prognostic value. In addition, accurate quantification of serial change in effusion volume is necessary in assessing pericardial disease and making a decision of immediate drainage. This study was performed to evaluate the efficacy of 2-D echocardiographic quantification of pericardial effusion.

Method

The study populations are 22 patients with large pericardial effusion whose volume of effusion is confirmed by paracentesis or surgical drainage. Through the echocardiographic review, the volume of pericardial sac and heart was calculated by method of D'cruz and then, the effusion volume was derived as the difference of two volumes. Each echocardiographically calculated volume of pericardial effusion was compared with the measured volume drained percutaneously or surgically.

Results

The volume of pericardial effusion calculated echocafdiographically was excellently correlated with the drained volume(r=0.90, p < 0.01). The echo-free space was well correlated with the volume of pericardial effusion in the anterior aspect of the heart(r=0.7I, p < 0.01), but not in the posterior aspect.

Conclusion

2-D echocardiographic Quantification of pericardial effusion is simple and reliable method, and its clinical efficacy may be great.

Keywords: Pericardial Effusion, Quantification, 2-D Echocardiography.

References

1). D'cruz I, Hoffman PK. A new cross sectional echocardiographic method for estimating the volume of large pericardial effusions. Br Heart J. 66:448–451. 1991.
2). Singh S, Wann LS, Schuchard GH, Klopfenstein HS, Leimgruber PP, Keelan MH, Brooks HL. Right ventricular and right atrial collapse in patients with cardiac tarnponade-a combined echocardiographic and hemodynamic study. Circulation. 70:966–971. 1984.
3). Feigenbaum H, Zary a, Waldhausen JA. Use of ultrasound in the diagnosis of pericardial effusion. Ann Intern Med. 65:443–452. 1966.
crossref
4). Horowitz MS, Schulz CS, Stinson EB, Harrison DC, Popp RL. Sensitivity and specificity of echocardiographic diagnosis of pericardial effusion. Circulation. 50:239–247. 1974.
crossref
5). Parameswaran R, Goldberg H. Echocardiogrphic quantitation of pericardial effusion of pericardial effusion. Chest. 83:767–770. 1983.
6). Prakash R, Moorthy K, Delvicario L, Aronow WS. Reliability of echocardiography in quantitating pericardial effusion: A prospective study. JCU. 5:398–402. 1977.
crossref
7). Eisenberg MJ, Oken K, Guerrero S, Saniei MA, Schiller NB. Prognostic value of echocardiography in hospitalized patients with pericardial effusion. Am J Cardiol. 70:934–939. 1992.
crossref
8). Arvin S. Echocardiography. p. 224. New york: Churchill Livingstone;1984.
crossref
9). Himelman RB, Kircher B, Rockey DC, Schiller NB. Inferior vena cava plethora with blunted respiratory response: A sensitive echocardiographic sign of cardiac tamponade. J Am Coll Cardiol. 12:1470–1477. 1988.
10). Menapace FJ. Two-dimensional echocardiography in pericardial disease. Giuliani E, editor. ed.Two-dimensional real-time ultrasonic imaging of the heart. p. 182. Boston: Martinus Nijhoff;1985.
crossref
11). Sutton MJ, Oldershaw PJ, editors. eds.:. Echocardiography and Doppler. p. 384. New York: Blackwell;1989.
12). Vazquez de Prada JA, Jiang L, Handshumacher BS, Xie SW, Rivera JM, Schwammenthal E, Guerrero JL, Weyman AE, Levine RA, Picard MH J. Quantification of pericardial effusions by three-dimensional echocardiography. J Am Coll Cardiol. 24:254–259. 1994.

Fig. 1.
Diagram showing measurement of each parameters in the quantitation of pericardial effusion.
jkse-3-196f1.tif
Fig. 2.
Example of measurement of each parameters.
jkse-3-196f2.tif
Fig. 3.
Correlation between drained volume and measured volume of pericardial effusion.
jkse-3-196f3.tif
Fig. 4.
Correlation between anterior echo-free space and volume of pericardial effusion.
jkse-3-196f4.tif
Table 1.
Clinical characteristics and echocardiographic findings of study populations
Number of patients 22
Sex(Male/Female) 16/6
Age(years) 48.27 ± 19.64
Clinical diagnosis  
Tuberculous 12
Malignant 6
Viral 2
Uremic 2
Draining Method  
Pericadiocentesis 14
Surgical Drainage 8
Drained PE volume 1125.82 ± 624.35
Echocardiographic finding  
Estimated PE volume 1035.45 ± 506.21
Echo-free space(Ant) 1.14 ± 0.96
Echo-free space(Post) 2.55 ± 1.09
RV or RA collapse 6/22
CT ratio on admission 0.73 ± 0.08

Echo; Echocardiography, PE; Pericardial effusion, Ant; Anterior, Post; Posterior, RV; Right ventricle, RA; Right atrium

Table 2.
Correlation coeffciencies between the volume of pericardial effusion and each parameters
parameters r P value Equation
Calculated volume 0.899 <0.01 y=0.892 × −22.529
Echo-free space      
Ant 0.708 <0.01 y=489.23× +496.54
Post –0.052 NS y=–36.75×+1213.39
CT ratio 0.115 NS y=913.39 ×+456.18

Ant: Anterior aspect, Post: Posterior aspect, CT: Cardiothoracic

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