70 year old man with history of multiple VT ablations, suspected cardiac sarcoidosis, referred for repeat cardiac MRI to evaluate Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 80 ml/m2 (normal range: 74+/-15), the LVEDV is 161 ml (normal range 142+/-34), the LV end systolic volume index is 36 ml/m2 (normal range 25+/-9), the LVESV is 73 ml (normal range 47+/-19). There are no regional wall motion abnormalities. There is persistent late gadolinium enhancement in the basal lateral and a small focus of the basal anterior wall, which were seen on the previous study but appear more hyperintense in signal today. This could be clinically consistent with the patient's history of recent previous endocardial ablation, otherwise a prior myocardial infarction could be considered.Left AtriumThe left atrium is normal in size . Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 78 ml/m2 (normal range 82+/-16), the RVEDV is 158 ml (normal range 142+/-31), the RV end systolic volume index is 37 ml/m2 (normal range 31+/-9), and the RVESV is 76 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is trivial 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.AortaThe aortic root at the level of the SOV is 4.3 cm (stable from last exam). Ascending aorta at the level of the pulmonary bifurcation is upper normal (3.6cm). There is a left sided aortic arch with a normal brachiocephalic branching pattern.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated (33mm).Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis 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. Normal LV size with normal systolic function (EF 56%). When compared to the previous study, the volumes are smaller and the function appears visually improved. 2. There is persistent late gadolinium enhancement in the basal lateral and a small focus of the basal anterior wall, which were seen on the previous study but appear more hyperintense in signal today. This could be clinically consistent with the patient's history of recent previous endocardial ablation, otherwise a prior myocardial infarction could be considered.3. Normal size RV with normal systolic function (EF 52%). 4. Stable dimensions of sinus of valsalva and upper normal ascending aorta dimensions.5. Mild main pulmonary artery dilation. 