55 year old woman with AL amyloidosis and cardiac involvement, referred for interval assessment of cardiac amyloid. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 66%, the LV end diastolic volume index is 76 ml/m2 (normal range: 65+/-11), the LVEDV is 142 ml (normal range 109+/-23), the LV end systolic volume index is 26 ml/m2 (normal range 18+/-5), the LVESV is 49 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 93 g (normal range 114+/-24). There is mild concentric LVH (IVSd=12mm). There are no regional wall motion abnormalities present. The native myocardial T1 relaxation time is 1160ms in the basal septum. Based on native myocardial T1 mapping, the T1 time is moderately elevated throughout the ventricle. This is elevated, indicative of an infiltrative process (such as amyloid). The T1 time is not significantly different from the prior cardiac MRI on 6/9/15 (1150ms). Left AtriumThe left atrium is normal in size. There is lipomatous hypertrophy of the inter-atrial septum.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 66%, the RV end diastolic volume index is 56 ml/m2 (normal range 69+/-14), the RVEDV is 104 ml (normal range 110+/-24), the RV end systolic volume index is 19 ml/m2 (normal range 22+/-8), and the RVESV is 35 ml (normal range 35+/-13). Right 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.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 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.
1. The left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 66%. 2. The native myocardial T1 relaxation time is 1160ms. This is elevated, indicative of an infiltrative process (such as amyloid). The T1 time is not significantly different from the prior cardiac MRI on 6/9/15 (1150ms). 3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 66%.4. Overall, there is no significant change from prior study on 6/9/15.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.