A 29 year old female with history of sickle cell disease, repeated red blood cell transfusions and iron overload. A recent echocardiography showed mildly reduced systolic function. Referred to cardiac MRI to assess function and cardiac iron overload. Left VentricleThe left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 46%, the LV end diastolic volume index is 142 ml/m2 (normal range: 65+/-11), the LVEDV is 250 ml (normal range 109+/-23), the LV end systolic volume index is 76 ml/m2 (normal range 18+/-5), the LVESV is 134 ml (normal range 31+/-10), the LV mass index is 61 g/m2 (normal range 67+/-11), and the LV mass is 108 g (normal range 114+/-24). There is global mild hypokinesis with regional variation. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No evidence of myocardial iron overload (average T2-star time above 30ms).No intracavitary thrombus was noted.Left AtriumThe left atrium is mildly dilated. The LA volume is 109 ml.Right VentricleThe right ventricle is severely dilated with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 132 ml/m2 (normal range 69+/-14), the RVEDV is 234 ml (normal range 110+/-24), the RV end systolic volume index is 63 ml/m2 (normal range 22+/-8), and the RVESV is 111 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly 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 moderate 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 pericardial pericardial effusion.Extracardiac FindingsIron overload was noted in the liver (T2-star time of 9ms). No spleen was seen, consistent with auto-splenectomy. 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 severely dilated with mildly reduced systolic function, the LVEF is 46%. There is global mild hypokinesis with regional variation. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. No evidence of myocardial iron overload.4. There is biatrial mild dilation. 5. The right ventricle is severely dilated with normal systolic function, the RVEF is 52%. 6. There is moderate tricuspid regurgitation.7. Iron overload was noted in the liver.