55 year old woman with history of adriamycin as part of chemotherapy for breast cancer, referred for cardiac MRI to evaluate cardiac function. Left VentricleThe left ventricle is severely dilated (previously moderately dilated) with normal systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 115 ml/m2 (normal range: 65+/-11), the LVEDV is 200 ml (normal range 109+/-23), the LV end systolic volume index is 50 ml/m2 (normal range 18+/-5), the LVESV is 87 ml (normal range 31+/-10), the LV mass index is 34 g/m2 (normal range 67+/-11), and the LV mass is 60 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Normal myocardial T1 relaxation time. There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is mild-moderately dilated.Right VentricleThe right ventricle is severely dilated. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 140 ml/m2 (normal range 69+/-14), the RVEDV is 244 ml (normal range 110+/-24), the RV end systolic volume index is 71 ml/m2 (normal range 22+/-8), and the RVESV is 123 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsBilateral breast implants are present. There is low signal intensity in the liver associated with a significantly reduced T2* decay time of 12.7ms. Taken together, this may suggest iron overload of the liver or recent iron infusion. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. Severely dilated LV with normal systolic function (EF 56%). There is no late gadolinium enhancement to suggest previous underlying infiltrative, inflammatory or fibrotic myocardial processes.2. Severely dilated RV with normal systolic function (EF 50%). 3. Biatrial enlargement. 4. Low signal intensity in the liver associated with significantly reduced T2* decay time of 12.7ms, suggestive of iron overload in the liver or recent iron infusion. When compared to the previous cardiac MRI of 7/2014, the ventricular volumes have increased by one degree in size with no significant change in function. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.