Wednesday, June 23, 2010

CT scanning to help differentiate the cause of pericardial effusion

From the American Journal of Roentgenology:

RESULTS. Twenty-eight cases of malignant and 46 cases of benign pericardial effusion were identified. Mean pericardial thickening was greater in association with malignant disease (7.25 ± 2.91 mm) than with benign disease (4.11 ± 1.39 mm) (p less than 0.05). Abnormal pericardial thickening (p less than 0.05) and mediastinal lymph node enlargement (p less than 0.001) were statistically significant findings of malignant pericardial effusion. The sensitivity of abnormal pericardial thickening was 42.9% and that of mediastinal lymph node enlargement was 60.7%.

CONCLUSION. CT findings of irregular pericardial thickening and mediastinal lymphadenopathy have the potential to be reliably specific findings suggesting the presence of malignant pericardial effusion. It would be useful, however, to obtain pericardial fluid or tissue for cause-based management of pericardial effusion, especially in patients with malignant disease.

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