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James A. Heinsimer, MD; Gary J. Collins, MD; Marilyn H. Burkman, RDMS; Leroy Roberts, Jr, MD; James T. T. Chen, MD

JAMA. 1987;257(23):3266-3268.

Abstract
We performed a prospective, blinded, controlled study to test the hypothesis that supine cross-table lateral chest roentgenograms might have an advantage over conventional lateral chest roentgenograms for the detection of pericardial effusion using the epicardial fat stripe sign. In comparison with echocardiography as the gold standard, we found that supine cross-table lateral chest roentgenograms had greater sensitivity (51%) for pericardial effusions than conventional lateral chest roentgenograms (sensitivity, 31%). Specificity was essentially the same for both techniques. A large pericardial effusion was more readily detected by supine cross-table lateral chest roentgenograms (86%) than by the conventional lateral chest roentgenograms (36%). We conclude that a supine cross-table lateral chest roentgenogram should be included in the evaluation of patients with suspected pericardial effusion or in patients in whom a large cardiac silhouette is detected on a standard chest roentgenogram.

(JAMA 1987;257:3266-3268)

Author Affiliations
From the Division of Cardiology, the Departments of Medicine (Drs Heinsimer, Collins, and Burkman) and Radiology (Drs Roberts and Chen), Duke University Medical Center, Durham, NC. Dr Heinsimer is now with the Division of Cardiology, the Department of Medicine, Harper Hospital, Wayne State University School of Medicine, Detroit.

Footnotes
Reprint requests to Noninvasive Cardiology Laboratory, Harper Hospital, 3990 John R St, Detroit, MI 48201 (Dr Heinsimer).

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