69 year old man with PVC initiated VT/VF, referred for cardiac MRI for evaluation of scar burden prior to ablation. Left VentricleThe left ventricle is mildly dilated with severely reduced systolic function. The overall LV ejection fraction is 27%, the LV end diastolic volume index is 117 ml/m2 (normal range: 74+/-15), the LVEDV is 242 ml (normal range 142+/-34), the LV end systolic volume index is 85 ml/m2 (normal range 25+/-9), the LVESV is 176 ml (normal range 47+/-19), the LV mass index is 48 g/m2 (normal range 85+/-15), and the LV mass is 100 g (normal range 164+/-36). LV dysfunction is global with regional variation.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with moderately reduced systolic function. The overall RV ejection fraction is 35%, the RV end diastolic volume index is 95 ml/m2 (normal range 82+/-16), the RVEDV is 197 ml (normal range 142+/-31), the RV end systolic volume index is 62 ml/m2 (normal range 31+/-9), and the RVESV is 129 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.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 grossly normal in size.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsProminent left chest ICD artifact is noted. 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. The left ventricle is mildly dilated with severely reduced systolic function. The overall LV ejection fraction is 27%.2. The right ventricle is normal in size with moderately reduced systolic function. The overall RV ejection fraction is 35%.3. The presence or absence of late gadolinium enhancement could not be determined in this study. Although gadolinium was administered, only one post-contrast image was acquired and the patient refused to complete the study due to discomfort in left chest wall. Subsequent exam suggested musculoskeletal cause of discomfort. No evidence of ICD problems by exam and interrogation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.