Vilela Eduardo M, Ruivo Catarina, Guerreiro Claudio E, Silva Marisa P, Ladeiras-Lopes Ricardo, Caeiro Daniel, Morais Gustavo P, Primo João, Braga Pedro, Ferreira Nuno, Nunes José Pedro L, Ribeiro Vasco Gama
Cardiology Department, Vila Nova de Gaia / Espinho Hospital Center EPE, Rua Conceição Fernandes, 4434-520 Vila Nova de Gaia, Portugal.
Leiria Hospital Center, Leiria, Portugal.
Ther Adv Cardiovasc Dis. 2018 Nov;12(11):299-307. doi: 10.1177/1753944718792413. Epub 2018 Aug 15.
Pericardial effusion (PE) can develop in several pathological scenarios, and is often initially evaluated by means of echocardiography. Computed tomography (CT) has been used as an aid in the management of patients presenting with PE, in selected cases. The role of CT-guided pericardiocentesis in contemporary practice, however, remains not fully ascertained. We aimed at presenting a systematic review concerning the state-of-the-art of this technique.
A systematic review of published data on the use of CT for guiding pericardiocentesis was carried out (search performed on PubMed, ISI Web of Knowledge and Scopus databases).
From title and abstract analysis, 14 articles were included that met the prespecified criteria. After full-text analysis, six articles were excluded. The eight articles under analysis included a total of 635 procedures performed in 571 patients. CT guidance was mostly used in a postoperative setting (364 procedures). Most procedures were done mainly for therapeutic purposes (528 procedures). Success rates ranged from 94% to 100%. Complications ranged from 0% to 7.8%.
CT-guided pericardiocentesis is a useful technique in the approach to PE, in several clinical scenarios. Its use can be especially relevant in the postoperative period, as well as in individuals with suboptimal image quality (as assessed by echocardiography, for the moment the first choice in the approach to most cases of PE).
心包积液（PE）可在多种病理情况下发生，通常最初通过超声心动图进行评估。在某些特定病例中，计算机断层扫描（CT）已被用于辅助管理患有PE的患者。然而，在当代实践中，CT引导下心包穿刺术的作用仍未完全明确。我们旨在对该技术的最新进展进行系统综述。
对已发表的关于使用CT引导心包穿刺术的数据进行系统综述（在PubMed、ISI Web of Knowledge和Scopus数据库中进行检索）。
通过标题和摘要分析，纳入了14篇符合预定标准的文章。经过全文分析，排除了6篇文章。分析的8篇文章共包括在571例患者中进行的635例操作。CT引导主要用于术后情况（364例操作）。大多数操作主要是为了治疗目的（528例操作）。成功率在94%至100%之间。并发症发生率在0%至7.8%之间。
在多种临床情况下，CT引导下心包穿刺术是处理PE的一种有用技术。其应用在术后时期以及图像质量欠佳的个体中可能尤为重要（目前，超声心动图是大多数PE病例处理的首选方法，用于评估图像质量）。
