Purpose: This study sought to define the relationship between clinical data of patients diagnosed with pericardial effusion following computerized tomography (CT) scan and the superior and inferior vena cava (SVC, IVC) aspect ratio (height/width) to establish radiological tool for determining patient’s hemodynamic status.
Materials and Methods: Study population included 177 patients with pericardial effusion diagnosed by CT scan. Of those patients, 93 had tamponade (diagnosed by a combination of clinical and echocardiographic assessment). Pericardial effusion volume, SVC and IVC diameters were measured, a new variable- lateral to anterior-posterior ratio, aspect ratio, was calculated to reflect vessels shape.
Results: Mean pericardial effusion volume was 639.85±254.27cc with no statistical difference between the cardiac tamponade and the non-compressive groups. Patients with congestive heart failure (CHF) had significantly higher volumes relative to all other groups (mean, SD; 955.84 205.08cc).
Comparing the aspect ratio of SVC and IVC between the cardiac tamponade and the non-compressive group showed significant difference in the SVC aspect ratio between the cardiac tamponade and the non-compressive effusion groups (0.971±0.176 vs. 0.906±0.134 respectively, p-value 0.017). Age stratification showed that in the 61-80 age group a mean SVC diameter ratio of 1.000±0.947 in the cardiac tamponade group compared with 0.875±0.123 in the non-compressive group (p-value 0.0002). A Cutoff value of SVC aspect ratio of 0.952 showed 54.5% sensitivity, 81.8% specificity, +LR 2.99, -LR 0.58.
Conclusion: Patients diagnosed with pericardial effusion SVC aspect ratio value of 0.952 has high accuracy detection for cardiac tamponade and hemodynamic compromise.
