title: Quantification of pericardial effusions by three-dimensional echocardiography.
abstract: OBJECTIVE
  The purpose of this study was to examine the accuracy of three-dimensional echocardiography for the quantification of asymmetric pericardial effusion volume and to compare this new technique with two-dimensional echocardiography.
  
  
  BACKGROUND
  Quantification of pericardial effusion by two-dimensional echocardiography relies on a symmetric distribution of the fluid. Three-dimensional echocardiography can quantitate volume without these limitations, but its accuracy for pericardial effusion volume has not yet been assessed.
  
  
  METHODS
  In six open chest dogs, 41 different asymmetrically distributed pericardial effusions of known volume were created by serial infusions of fluid through a pericardial catheter. The hearts were imaged using an automated echocardiographic method that integrates three-dimensional spatial and imaging data. The surfaces of the pericardial sac and heart were then reconstructed, and the volumes of pericardial effusions were calculated. Two-dimensional echocardiography was performed simultaneously, and volumes were calculated using the prolate ellipsoid method. Asymmetric distribution of the fluid was obtained by applying localized hydrostatic pressure to the pericardium.
  
  
  RESULTS
  The volumes of pericardial effusion quantified using three-dimensional echocardiography correlated well with actual volumes (y = 1.0x - 1.4, SEE = 7.7 ml, r = 0.98). Two-dimensional echocardiography had an acceptable correlation (y = 1.0x + 2.3, SEE = 23 ml, r = 0.84), but a marked degree of variation from the true value was observed for any individual measurement.
  
  
  CONCLUSIONS
  Three-dimensional echocardiography accurately quantifies pericardial effusion volume in vivo, even when the fluid is distributed asymmetrically, whereas two-dimensional echocardiography is less reliable. This new technique may be of clinical value in quantitating pericardial effusion, especially in the serial evaluation of asymmetric or loculated effusions.
authors.affiliation: Cardiac Unit, Massachusetts General Hospital, Boston 02114.
authors.forename: J A
authors.initials: JA
authors.lastname: Vazquez de Prada
authors.forename: L
authors.initials: L
authors.lastname: Jiang
authors.forename: M D
authors.initials: MD
authors.lastname: Handschumacher
authors.forename: S W
authors.initials: SW
authors.lastname: Xie
authors.forename: J M
authors.initials: JM
authors.lastname: Rivera
authors.forename: E
authors.initials: E
authors.lastname: Schwammenthal
authors.forename: J L
authors.initials: JL
authors.lastname: Guerrero
authors.forename: A E
authors.initials: AE
authors.lastname: Weyman
authors.forename: R A
authors.initials: RA
authors.lastname: Levine
authors.forename: M H
authors.initials: MH
authors.lastname: Picard
mesh_terms: D000465:Algorithms; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D010490:Pericardial Effusion / Q000000981:diagnostic imaging*