患儿男，6岁，主诉发热、咳嗽半个月，乏力、呼吸困难5天。査体：T380C。呼吸急促，双肺闻及中细湿啰音。心前区饱满，心尖搏动弥散，心浊音界稍扩大，心音低钝遥远。腹胀，肝肋下5cm，质软缘钝。颈静脉回流征（+)，移动性浊音（+),双下肢水肿。如果超声检査未显示明确心包积液，下列间接征象中最有助于心包积液诊断的是

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