49 year old man with history of previous pulmonary sarcoidosis, coronary disease with previous PCI, and worsening LV dysfunction who was referred for cardiac MRI to evaluate for possible sarcoidosis. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 8%, the LV end diastolic volume index is 120 ml/m2 (normal range: 74+/-15), the LVEDV is 204 ml (normal range 142+/-34), the LV end systolic volume index is 110 ml/m2 (normal range 25+/-9), the LVESV is 188 ml (normal range 47+/-19), the LV mass index is elevated at 125 g/m2 (normal range 85+/-15), and the LV mass is 214 g (normal range 164+/-36). There is global hypokinesis with regional variation. For example, akinesia is demonstrated by the anterior and basal two thirds of the inferior walls, severe hypokinesia of the septum and apical two thirds of the lateral wall. There is no evidence of myocardial edema. There is no late gadolinium enhancement to suggest myocardial fibrosis, infiltration or inflammation. The global relative enhancement ratio is normal. No intracardiac thrombus.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with moderately reduced systolic function. The overall RV ejection fraction is 40%, the RV end diastolic volume index is 81 ml/m2 (normal range 82+/-16), the RVEDV is 138 ml (normal range 142+/-31), the RV end systolic volume index is 48 ml/m2 (normal range 31+/-9), and the RVESV is 82 ml (normal range 54+/-17).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 trace 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 evidence of pericardial inflammation or effusion.Extracardiac FindingsA right adrenal mass is present which measures 4.2 x 4.4 cm on the coronal view. This is a heterogeneous mass with areas of enhancement, better characterized on the MR abdomen performed 12/8/2015.
1. Severely dilated left ventricle with severely reduced systolic function (EF = 8%). 2. Normal sized RV with moderately reduced systolic function (EF = 40%). 3. Moderately dilated left atrium. 4. No evidence of late gadolinium enhancement to suggest myocardial inflammation, infiltration or fibrosis. 5. Heterogeneous right adrenal mass, better characterized by dedicated abdominal imaging to be performed today. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.