20 year old male with Tetralogy of Fallot s/p repair, s/p pulmonary valve replacement. Referred for research cardiovascular MRI to evaluate right ventricular volume and function Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 93 ml/m2 (normal range: 74+/-15), the LVEDV is 173 ml (normal range 142+/-34), the LV end systolic volume index is 34 ml/m2 (normal range 25+/-9), the LVESV is 63 ml (normal range 47+/-19), the LV mass index is 64 g/m2 (normal range 85+/-15), and the LV mass is 119 g (normal range 164+/-36). There is systolic septal flattening, suggesting increased RV systolic pressure. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is severely enlarged with moderately reduced systolic function. The overall RV ejection fraction is 38%, the RV end diastolic volume index is 168 ml/m2 (normal range 82+/-16), the RVEDV is 309 ml (normal range 142+/-31), the RV end systolic volume index is 104 ml/m2 (normal range 31+/-9), and the RVESV is 192 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately 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 ValveThere is a bioprosthetic pulmonary valve in place. There is moderate pulmonic valve regurgitation and moderate pulmonic valve stenosis.Regurgitant fraction 25%. Peak velocity 3.5 m/sTricuspid 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.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteriesThe main pulmonary artery is moderately dilated (35mm). Right pulmonary artery has a diameter of 34mm and receives 53% of cardiac output. Left pulmonary artery has a diameter of 27mm and recieves 47% of the cardiac output.Venous AnatomyThe SVC and IVC are normal in size and 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.
This is a limited cardiac MRI without contrast performed for research purposes.1. Severe right ventricular dilation with moderately reduced systolic function (RVEF 38%, RVEDV indexed 168 mL/m2)2. A bioprosthic valve is noted in the pulmonic position. Moderate pulmonic valve insufficiency and stenosis are noted.3. Moderate dilation of pulmonary artery.4. Normal left ventricular size and systolic function (LVEF 63%). I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.