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Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography

OBJECTIVE: Pericardial effusion may present clinically as pleuritic chest pain, dyspnea, or hemodynamic compromise and is a frequent finding in computerized tomographic pulmonary angiography (CTPA) exams. We hypothesized that CTPA-based analysis of the cardiac chamber volumes can be used to predict...

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Autores principales: Granot, Yoav, Rozenbaum, Zach, Yashar, Hila, Shalmon, Tamar, Berliner, Shlomo, Aviram, Galit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Institute of Radiology. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733607/
https://www.ncbi.nlm.nih.gov/pubmed/36169378
http://dx.doi.org/10.1259/bjr.20220106
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author Granot, Yoav
Rozenbaum, Zach
Yashar, Hila
Shalmon, Tamar
Berliner, Shlomo
Aviram, Galit
author_facet Granot, Yoav
Rozenbaum, Zach
Yashar, Hila
Shalmon, Tamar
Berliner, Shlomo
Aviram, Galit
author_sort Granot, Yoav
collection PubMed
description OBJECTIVE: Pericardial effusion may present clinically as pleuritic chest pain, dyspnea, or hemodynamic compromise and is a frequent finding in computerized tomographic pulmonary angiography (CTPA) exams. We hypothesized that CTPA-based analysis of the cardiac chamber volumes can be used to predict the hemodynamic significance of pericardial effusion (HsPE) as compared with echocardiography. METHODS: Retrospective analysis of consecutive patients who underwent CTPA and echocardiography between January 2009 and November 2017 that ruled-out acute pulmonary embolism was included. Differences in cardiac chamber volumes were investigated in correlation to echocardiographic evidence of HsPE. RESULTS: The final cohort included 208 patients, of whom 22 (11%) were diagnosed with HsPE. The HsPE patients had much smaller right cardiac chamber volumes (Median 78.8 ml (IQR 72.4–89.1)) than patients without HsPE (Median 115.1 ml (IQR 87.4–150). A decision tree for the prediction of HsPE showed multiple cutoff values. Right atrium (RA) volume had the best accuracy (area under the curve 0.851, 95% confidence interval 0.776–0.925, p < .001) for predicting the presence of HsPE. An RA volume ≤86 ml yielded a sensitivity of 95.5%, a specificity of 64%, and a NPV of 99.2% for the presence of HsPE. CONCLUSION: CTPA-based volumetric information with focus on the RA volume may help predict the presence of HsPE. ADVANCES IN KNOWLEDGE: Pericardial effusion is a frequent finding in CTPA exams. Our study shows that CTPA-based volumetric information can predict the presence of HsPE with RA volume as the best indicator.
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spelling pubmed-97336072022-12-19 Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography Granot, Yoav Rozenbaum, Zach Yashar, Hila Shalmon, Tamar Berliner, Shlomo Aviram, Galit Br J Radiol Full Paper OBJECTIVE: Pericardial effusion may present clinically as pleuritic chest pain, dyspnea, or hemodynamic compromise and is a frequent finding in computerized tomographic pulmonary angiography (CTPA) exams. We hypothesized that CTPA-based analysis of the cardiac chamber volumes can be used to predict the hemodynamic significance of pericardial effusion (HsPE) as compared with echocardiography. METHODS: Retrospective analysis of consecutive patients who underwent CTPA and echocardiography between January 2009 and November 2017 that ruled-out acute pulmonary embolism was included. Differences in cardiac chamber volumes were investigated in correlation to echocardiographic evidence of HsPE. RESULTS: The final cohort included 208 patients, of whom 22 (11%) were diagnosed with HsPE. The HsPE patients had much smaller right cardiac chamber volumes (Median 78.8 ml (IQR 72.4–89.1)) than patients without HsPE (Median 115.1 ml (IQR 87.4–150). A decision tree for the prediction of HsPE showed multiple cutoff values. Right atrium (RA) volume had the best accuracy (area under the curve 0.851, 95% confidence interval 0.776–0.925, p < .001) for predicting the presence of HsPE. An RA volume ≤86 ml yielded a sensitivity of 95.5%, a specificity of 64%, and a NPV of 99.2% for the presence of HsPE. CONCLUSION: CTPA-based volumetric information with focus on the RA volume may help predict the presence of HsPE. ADVANCES IN KNOWLEDGE: Pericardial effusion is a frequent finding in CTPA exams. Our study shows that CTPA-based volumetric information can predict the presence of HsPE with RA volume as the best indicator. The British Institute of Radiology. 2022-12-01 2022-10-11 /pmc/articles/PMC9733607/ /pubmed/36169378 http://dx.doi.org/10.1259/bjr.20220106 Text en © 2022 The Authors. Published by the British Institute of Radiology https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
spellingShingle Full Paper
Granot, Yoav
Rozenbaum, Zach
Yashar, Hila
Shalmon, Tamar
Berliner, Shlomo
Aviram, Galit
Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title_full Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title_fullStr Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title_full_unstemmed Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title_short Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
title_sort evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
topic Full Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733607/
https://www.ncbi.nlm.nih.gov/pubmed/36169378
http://dx.doi.org/10.1259/bjr.20220106
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