59 year old male with history of sarcoid by LN biopsy, aortic aneurysm repair s/p repair who presents for cardiac MRI for further evaluation of cardiac sarcoid involvement. Left VentricleThe left ventricle is normal in size and systolic function. No significant interval change is noted when compared to the previous cardiac MRI. The overall LV ejection fraction is 63% (compared to 61%), the LV end diastolic volume index is 85 ml/m2 (normal range: 74+/-15), the LVEDV is 198 ml (normal range 142+/-34), the LV end systolic volume index is 32 ml/m2 (normal range 25+/-9), the LVESV is 74 ml (normal range 47+/-19), the LV mass index is 51 g/m2 (normal range 85+/-15), and the LV mass is 119 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is linear, mid-myocardial late gadolinium enhancement in the basal inferior wall to suggest an underlying fibrosing, infiltrative, or inflammatory process. No intracardiac thrombus.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 43 % (compared to 46%), the RV end diastolic volume index is 102 ml/m2 (normal range 82+/-16), the RVEDV is 237 ml (normal range 142+/-31), the RV end systolic volume index is 58 ml/m2 (normal range 31+/-9), and the RVESV is 135 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trace 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 common origin of the innominate and left common carotid arteries. There has been a valve sparing interposition graft procedure. The anastomosis appears to terminate at the expected location of the sinotubular junction. The sinus of Valsalva is mildly dilated, stable at 44 mm using similar measurement technique by the same observer (nonorthogonal/axial technique). 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 pericardial effusion.Extracardiac FindingsLow lung volumes with perihilar increased signal compatible with patient's known pulmonary involvement with sarcoidosis. Stable perihilar lymphadenopathy. Splenomegaly.On the coronal scout images, a portion of the kidneys are included in the field-of-view. There is a right renal cyst with apparent solid exophytic component measuring 15 mm. Further evaluation with a dedicated renal ultrasound is recommended.
1. The left ventricle remains normal in size and systolic function (LVEF 63%, compared to 61%)2. The right ventricle remains normal in size and systolic function (RVEF 43%, compared to 46%)3. Stable linear, mid-myocardial late gadolinium enhancement in the basal inferior wall suggestive of myocardial involvement with sarcoidosis. 4. Postsurgical changes compatible with valve sparing interposition graft procedure of the ascending aorta. Stable ectasia of the sinus of Valsalva.5. On the coronal scout images, a portion of the kidneys are included in the field-of-view. There is a right renal cyst with apparent solid exophytic component measuring 15 mm. Further evaluation with a dedicated renal ultrasound is recommended. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.