A COMPARISON OF VENOUS ANGIOGRAPHY AND RADIOISOTOPE HEART SCANNING IN THE DIAGNOSIS OF PERICARDIAL EFFUSION

¹ From the Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland

1. In humans, there appears to be a shift of pericardial fluid with shift in position. In the majority of cases, sufficient fluid is retained above the right atrium to render the carbon dioxide method accurate in evaluating effusion. However, in some cases fluid shift may result in a normal or equivocal carbon dioxide study.

2. Because of this pericardial fluid shift, a re-evaluation of these cases now called "equivocal" may be possible. Those with normal wall thickness on carbon dioxide angiography and equivocal wall thickness (5-10 mm.) on radiopaque angiography may indicate free effusion in the range of 100 cc. Those cases with equivocal wall thickness by both carbon dioxide and radiopaque angiography may represent atrial wall thickening, pericardial tumor or pericardial effusion. No clear differentiation can be made in the latter cases.

3. Venous angiography is a more sensitive and reliable test than cardiac photoscanning for pericardial effusion in the critical range of 200 to 300 cc. of fluid.

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