title: The Biplane Modified Simpson's Method Accurately Estimates Pericardial Effusion Volume: A Comparison with Pericardiocentesis.
abstract: BACKGROUND
  Pericardial effusion (PE) volume is often assessed semiqualitatively by echocardiography and categorized into minimal, small, moderate, or large. Several methods of echocardiographic quantification have been proposed, but their application is limited either by complexity or inaccuracy. We evaluated the accuracy of PE volume quantification by two-dimensional transthoracic echocardiogram (2DTTE) and commercially available volume quantification software in patients undergoing pericardiocentesis.
  
  
  METHODS
  In a retrospective case series, immediate preprocedure echocardiograms of 33 patients for pericardiocentesis were analyzed. 2DTTE using the Simpson's method was adopted for volume measurement in the apical two- and four-chamber views. Pericardial fluid volume was calculated by taking the difference between volumes obtained by tracing the epicardial border of the heart and the pericardium. Postprocedure echocardiograms were performed to verify adequate pericardiocentesis.
  
  
  RESULTS
  The mean pericardiocentesis fluid volume was 725.1 ± 299.5 mL (range, 250-1420 mL). The average volume estimated echocardiographically by the Simpson's method was 657.5 ± 276.9 mL (range, 205.7-1193.2 mL). There was strong direct linear correlation between echocardiographic and pericardiocentesis-derived volumes (P < 0.001, r = +0.823). Echocardiography underestimated PE volume by a mean of 9.3%.
  
  
  CONCLUSIONS
  Two-dimensional transthoracic echocardiography using biplane Simpson's method of disks can simply and accurately estimate PE volume.
authors.affiliation: Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Khosraviani
authors.affiliation: Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Ythan
authors.initials: Y
authors.lastname: Goldberg
authors.affiliation: Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Behzad
authors.initials: B
authors.lastname: Salari
authors.affiliation: Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York.|The Russell H. Morgan Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Nariman
authors.initials: N
authors.lastname: Nezami
authors.affiliation: Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Peng
authors.affiliation: Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Cynthia C
authors.initials: CC
authors.lastname: Taub
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis*; D020519:Pericardiocentesis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
keywords: Simpson's rule; pericardial effusion; pericardiocentesis; two-dimensional transthoracic echocardiogram