A 57 year old male with history of lymphoplasmacytic lymphoma and known gastrointestinal amyloidosis. A recent echocardiography showed normal left ventricular function with hypertrophy up to 15mm in the septum. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 69 ml/m2 (normal range: 74+/-15), the LVEDV is 150 ml (normal range 142+/-34), the LV end systolic volume index is 28 ml/m2 (normal range 25+/-9), the LVESV is 61 ml (normal range 47+/-19). There is concentric hypertrophy with a maximum of 15 mm at the basal infero-septum at end diastole. There is late gadolinium enhancement in a diffuse pattern with multiple areas of prominent enhancement. In the clinical context of this patient, these findings suggest the presence of cardiac amyloid. Native T1 mapping also suggests abnormal myocardial signal consistent with amyloid.No intracavitary thrombus.No iron overload.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with low-normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 76 ml/m2 (normal range 82+/-16), the RVEDV is 165 ml (normal range 142+/-31), the RV end systolic volume index is 38 ml/m2 (normal range 31+/-9), and the RVESV is 83 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly 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 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 dilated (34 mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. Probable catheter in SVC.PericardiumThere is a small pericardial effusion.Extracardiac FindingsNo lymphadenopathy was noted. 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 LVEF is 59%.2. There is concentric hypertrophy.3. There is late gadolinium enhancement in a diffuse pattern with multiple areas of prominent enhancement. In the clinical context of this patient, these findings suggest the presence of cardiac amyloid. 4. Native T1 mapping also suggests abnormal myocardial signal consistent with amyloid.5. The right ventricle is normal in size with low-normal systolic function, the RVEF is 50%. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.