Pericardial Thickness Measured With Transesophageal Echocardiography: Feasibility and Potential Clinical Usefulness

AbstractObjectives. This study assessed the reliability of transesophageal echocardiographic measurements of pericardial thickness and the potential diagnostic usefulness of this technique.Background. Transthoracic echocardiography cannot reliably detect thickened pericardium. The superior resolution achieved with transesophageal echocardiography should allow better pericardial definition.Methods. Pericardial thickness measured at 26 locations in 11 patients with constrictive pericarditis who underwent intraoperative transesophageal echocardiography was compared with pericardial thickness measured with electron beam computed tomography. Intraobserver and interobserver variabilities were determined. Pericardial thickness was then measured in 21 normal subjects. With these values as a guide, two observers reviewed 37 transesophageal echocardiographic studies to determine whether echocardiographic measurement of pericardial thickness could be used to distinguish diseased from normal pericardium.Results. The correlation between echocardiographic and computed tomographic measurements (r ≥ 0.95, SE ≤ 0.06 mm, p < 0.0001) was excellent. The ±2 SD limits of agreement were ±1.0 mm or less for pericardial thickness