58 year old male with a history of recurrent atrial fibrillation status-post ablation referred for cardiac MRI prior to repeat ablation. Left VentricleAssessment of systolic function limited by atrial fibrillation. The left ventricle is normal in size and systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 64 ml/m2 (normal range: 74+/-15), the LVEDV is 133 ml (normal range 142+/-34), the LV end systolic volume index is 28 ml/m2 (normal range 25+/-9), the LVESV is 132 ml (normal range 47+/-19), the LV mass index is 20 g/m2 (normal range 85+/-15), and the LV mass is 42 g (normal range 164+/-36). 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.Right VentricleThe right ventricle is normal in size and has low-normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 63 ml/m2 (normal range 82+/-16), the RVEDV is 130 ml (normal range 142+/-31), the RV end systolic volume index is 32 ml/m2 (normal range 31+/-9), and the RVESV is 65 ml (normal range 54+/-17).Left AtriumThe left atrium is normal in size (91ml). All four pulmonary veins drain normally into the left atrium. There is an early branch of a small pulmonary vein near the ostium of the right superior pulmonary vein. Late gadolinium enhancement images of the left atrium are of limited quality; however, the largest "ablation" gaps were probably around the left upper and right superior pulmonary veins. A smaller "ablation" gap was probably present around the right inferior pulmonary vein. The ablation line around the left inferior pulmonary vein is not well seen. The dimensions of the pulmonary veins at the ostium are:Right superior pulmonary vein: 19 x 15.5 mmRight inferior pulmonary vein: 14.6 x 11 mmLeft inferior pulmonary vein: 10.4 x 11.1 mmLeft superior pulmonary vein: 12.9 x 16.6 mmRight 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 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 (sinus of Valsalva 36x36x37 mm).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 FindingsThere are small mediastinal lymph nodes present. Multiple high T2-signal hepatic masses noted, which are statistically most likely hemangiomas or cysts. 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 normal in size and systolic function (LVEF 56%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration .2. The right ventricle is normal in size and has low-normal systolic function (RVEF 50%). 3. Normal left atrial volume.4. Normal pulmonary vein anatomy. 5. Left atrial LGE imaging was of limited quality; however, the largest "ablation" gaps were probably around the left upper and right superior pulmonary veins. A smaller "ablation" gap was probably present around the right inferior pulmonary vein. The ablation line around the left inferior pulmonary vein is not well seen.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.