Pericardial ultrasound

Indications for the study of pericardial ultrasound

Suspicion of the presence of pericardial effusion. Echocardiography is a very specialized study. In general echographic practice, researchers are limited only to determining the presence of pericardial effusion.

Preparing for pericardial ultrasound

1. Preparation of the patient. No patient preparation is required.
2. Position of the patient. The patient is examined in the supine position, and then in the sitting position. The gel is applied arbitrarily to the heart area.
3. Select the sensor. Use a 3.5 MHz sensor. Use a 5 MHz sensor for children and thin adults. Use the smallest sensor available in the diameter to perform the test through the intercostal spaces.
4. Adjustment of sensitivity of the device. Start the study by placing the sensor centrally in the upper abdomen (below the xiphoid process). Tilt the sensor to the right until you get a picture of the liver. Set the sensitivity level of the device to obtain optimal echogenicity and echostructure. The diaphragm should be visualized as a thin hyperechoic line along the posterior contour of the liver. Portal and hepatic veins should be visualized in the form of tubular anehogennye structures with neehogennym a lumen. The walls of the portal vein are hyperechoic, the hepatic veins do not have hyperechoic walls.

Scanning techniques

Start the examination from the upper central abdomen with a sensor with a small acoustic head close to the edge of the costal arch below the xiphoid process.

Tilt the sensor up to the head and ask the patient to take a deep breath. This usually produces a cross-section of the heart, then the study can be carried out during the entire respiratory cycle. If the sensor has a sufficiently small scanning surface, which allows investigation through the intercostal spaces, different cross sections can be obtained. But usually, if the sensor is not sufficiently small, the shadows from the edges are superimposed on the image. The blood is anechogenous. And the walls of the heart are echogenic. The diameter of the heart chambers varies depending on the stage of the cardiac cycle.

Pericardial effusion

The fluid around the heart is visualized as an anechoic band around the heart muscle. (Anechoic fat located in front can simulate fluid.) If there is a small amount of fluid, the shape of the strip may vary depending on the phase of the heart cycle. If there is a moderate amount of fluid, the apex of the heart moves freely against the background of the pericardial fluid. With large discharge, cardiac contractions can be limited.

It is impossible to differentiate serous effusion and blood from the data of the echography. With pericardial efflux of tumor or tubercular genesis after an acute stage, local or delimited pericardial effusion can be determined by adhesion of two layers of the pericardium. Internal ehostruktura appears as a result of inflammation or hemorrhage. Calcification in the pericardium is better determined by radiography.

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