Quantitation of Pericardial Fluid Volume: Volumetric Estimation Compared with Guideline-Based Linear Grading

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Pericardial effusion size is crucial for patient management.
• Current guideline-based linear echocardiographic measures may lack precision.
• Accurate volumetric quantification is needed for better assessment.

Purpose of the Study:

• To compare linear and 2D echocardiographic measures with drained pericardial fluid volume.
• To evaluate if volumetric quantification improves accuracy and grading of pericardial effusion size.

Main Methods:

• Retrospective study of 245 adults undergoing pericardiocentesis.
• Measurements included linear thickness, parasternal area, and apical 4-chamber Simpson's volumetric estimation.
• Drained pericardial fluid volume served as the reference standard.

Main Results:

• Linear and parasternal area methods showed modest correlation with drained volume.
• Apical 4-chamber Simpson's volumetric estimation demonstrated strong agreement (R² 0.88) and minimal bias.
• Volumetric categorization significantly improved agreement (κ 0.695) and accuracy (80.4%) compared to linear grading (κ 0.293; 49.4%).

Conclusions:

• Guideline-based linear grading of pericardial effusion is imprecise.
• A simple apical 4-chamber Simpson's volumetric approach is more accurate.
• This volumetric method enhances communication and serial follow-up of pericardial effusions.