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Diagnosis of pericardial effusion in children: a new radiographic sign

E W Spooner, L R Kuhns, A M Stern

    AJR. American Journal of Roentgenology
    |January 1, 1977
    PubMed

    Insights

    A new chest X-ray sign, a density band near the heart, may help detect pericardial effusions in children. This finding, potentially from epicardial fat, showed 83% accuracy in a radiologist study.

    Area of Science:

    • Pediatric Radiology
    • Cardiology
    • Diagnostic Imaging

    Background:

    • Pericardial effusion, fluid around the heart, can be challenging to diagnose in children.
    • A novel radiographic sign has been observed in anteroposterior chest films of children with pericardial effusions.

    Purpose of the Study:

    • To determine the incidence and diagnostic accuracy of a newly observed density band sign.
    • To evaluate the sign's reliability in identifying pericardial effusions in pediatric patients.

    Main Methods:

    • Retrospective analysis of chest radiographs from children with and without pericardial effusions.
    • Evaluation of the density band sign by independent radiologists.
    • In vitro studies to investigate potential causes of the density difference.

    Main Results:

    • The density band sign was observed in 6 of 17 children with confirmed pericardial effusion.
    • Radiologists achieved 83% sensitivity and specificity in detecting the sign in children with effusions versus controls.
    • In vitro studies did not support density differences between myocardium and varying osmolarity solutions.

    Conclusions:

    • The newly identified density band sign may be a useful indicator of pericardial effusion in children.
    • The sign is likely related to epicardial fat adjacent to pericardial fluid.
    • Further research is warranted to validate this imaging finding.

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