Illustrative cases in pericardial effusion misdetection: correlation of echocardiography and CT

Eight equivocal two-dimensional echocardiograms with concurrent CT scans were evaluated to identify potential pitfalls in pericardial effusion detection. By echocardiography, two pleural effusions were felt to be pericardial, two hemopericardiums were interpreted as normal myocardium, three loculated pericardial effusions were not seen or were misinterpreted as other mediastinal collections, and one epicardial lipoma was called a pericardial effusion. When the clinical suspicion for pericardial effusion does not correlate with echocardiographic findings, CT scanning may be the definitive arbiter of pericardial disease.