Weintraub A R, Schwartz S L, Smith J, Hsu T L, Pandian N G
Department of Medicine, New England Medical Center Hospitals, Boston, MA.
J Am Soc Echocardiogr. 1991 Nov-Dec;4(6):571-6. doi: 10.1016/s0894-7317(14)80215-0.
The utility of intracardiac two-dimensional echocardiography in the identification of pericardial effusion was assessed in five patients with pericardial effusion and cardiac tamponade. A 20 MHz, mechanically rotating ultrasound catheter was used for intracardiac imaging. In all five patients, intracardiac echocardiography yielded high resolution of images of the right atrial cavity, the right atrial wall, and the pericardial effusion. In two patients, right atrial collapse could be identified during real-time imaging. Although the entire right atrial cavity and the pericardial effusion could not be displayed in a single imaging field because of the limited depth of field associated with the 20 MHz catheter, manipulation of the catheter allowed visualization of the pericardial effusion and the parietal pericardium in each patient. The effusion was seen to surround the superior vena cava, as well, in all patients. After pericardiocentesis, the reduction in the size of the effusion and increase in the right atrial cavity size could be recognized by intracardiac echocardiography. The introduction and manipulation of the ultrasound catheter was easily performed without any complications. This experience presents one clinical application for intracardiac echocardiography and indicates its potential value in the invasive cardiac laboratory.
对5例心包积液和心脏压塞患者评估了心腔内二维超声心动图在识别心包积液方面的效用。使用一根20MHz的机械旋转超声导管进行心腔内成像。在所有5例患者中，心腔内超声心动图均能清晰显示右心房腔、右心房壁和心包积液的图像。在2例患者中，实时成像时可识别出右心房塌陷。尽管由于20MHz导管相关的景深有限，单个成像视野中无法显示整个右心房腔和心包积液，但通过操纵导管可使每位患者的心包积液和心包脏层可视化。在所有患者中，还可见积液围绕上腔静脉。心包穿刺术后，心腔内超声心动图可识别出积液大小的减小和右心房腔大小的增加。超声导管的插入和操作易于进行，无任何并发症。该经验展示了心腔内超声心动图的一种临床应用，并表明了其在侵入性心脏实验室中的潜在价值。
