50 year old man with heart/kidney transplant on 10/22/15, referred for serial MRI as part screening for cardiac allograft rejection. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 69 ml/m2 (normal range: 74+/-15), the end diastolic volume is 151 ml (normal range 142+/-34), the LV end systolic volume index is 33 ml/m2 (normal range 25+/-9), the LVESV is 71 ml (normal range 47+/-19), the LV mass index is 40 g/m2 (normal range 85+/-15), and the LV mass is 87 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. Quantitatively, the myocardial to skeletal T2-enhancement ratio is 1.2, which is in the normal range. The global relative enhancement is 2.2, which is in the normal range and has normalized since the last exam. The native myocardial T1 time in the interventricular septum is 1090-1110ms, which is elevated and may indicate edema or fibrosis, but this value measures similarly to the previous study. The extra-cellular volume fraction (ECV) is 31%, which is similar to that obtained on the previous exam. Left AtriumThe left atrium is consistent with transplant. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 78 ml/m2 (normal range 82+/-16), the RVEDV is 151 ml (normal range 142+/-31), the RV end systolic volume index is 33 ml/m2 (normal range 31+/-9), and the RVESV is 71 ml (normal range 54+/-17).Right AtriumThe right atrium is consistent with transplant.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 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 mildly dilated (32mm)Venous AnatomyThe SVC and IVC drain normally into the right atrium. There is persistent evidence of fibrin sheaths versus catheter within the SVC.PericardiumNo pericardial effusion noted on this study. There is no increased signal in the pericardium on T2-STIR and late gadolinium imaging to suggest edema or inflammation of the pericardium. Extracardiac FindingsSternal wires are present. There is diffuse low signal of the liver and spleen, which was seen on the previous study. 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 with normal systolic function. The overall LV ejection fraction is 53%. This is slightly lower than the previous exam.2. The myocardial to skeletal T2 ratio and global relative enhancement are normal. There is no late gadolinium enhancement. The native T1 myocardial relaxation time is stable, and the ECV is marginally elevated from previous.3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%. This is similar to the previous previous exam. 4. Mild tricuspid regurgitation. 5. See extracardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.