43 year old male with paroxsymal atrial fibrillation, refractory to medical therapy and plan for atrial fibrillation ablation. Pre procedure MRI. Left VentricleThe left ventricle is normal in size with globally decreased function. The overall LV ejection fraction is 37%. The LVEDV is 220 ml (normal range 142+/-34), the LV end diastolic volume index is 97 ml/m2 (normal range: 74+/-15), the LVESV is 82 ml (normal range 47+/-19) and the LV end systolic volume index is 61 ml/m2 (normal range 25+/-9). The LV mass is 203 g (normal range 164+/-36) and the LV mass index is 30 g/m2 (normal range 85+/-15). 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.Left AtriumThe left atrium is dilated. The left atrial appendage appears free of clot. Right VentricleThe right ventricle is normal in size with reduced function. The overall RV ejection fraction is 34%. The RVEDV is 264 ml (normal range 142+/-31), RV end diastolic volume index is 117 ml/m2 (normal range 82+/-16), the RVESV is 175 ml (normal range 54+/-17), and the RV end systolic volume index is 78 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve is trileaflet, 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 mild 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 obvious pericardial disease.Extracardiac FindingsSmall scattered pulmonary micronodules. Probable left renal cyst. Enhancing left thyroid lobe nodule measuring at least 2.9 cm. 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.
2.9 cm enhancing left thyroid lobe nodule. Correlation with thyroid ultrasound and possible tissue sampling depending on the ultrasound appearance of this lesion is suggested.Left ventricle is normal in size with globally decreased function. The overall LV ejection fraction is 37%. Right ventricle is normal in size with reduced function, RVEF is 34%There are 4 pulmonary veins draining into the left atrium. Left atrial appendage free of clot. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.