55 year old male s/p lung transplant, on immunosuppressive medication who is found to have pericardial effusion and septal bounce on recent echo - MRI to evaluate for pericardial disease, specifically constrictive pericarditis. Left VentricleThe left ventricle is normal sized with normal function. The overall LV ejection fraction is 57%. The LVEDV is 113 ml (normal range 142+/-34), the LV end diastolic volume index is 53 ml/m2 (normal range: 74+/-15), the LVESV is 49 ml (normal range 47+/-19) and the LV end systolic volume index is 23 ml/m2 (normal range 25+/-9). The LV mass is 92 g (normal range 164+/-36) and the LV mass index is 43 g/m2 (normal range 85+/-15). 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.There is septal bounce during diastole during breath-hold with leftward intraventricular septal straightening during inspiration consistent with interventricular dependence.Left AtriumThe left atrium is normal. Right VentricleThe right ventricle is normal sized with mildly decreased ejection fraction. The overall RV ejection fraction is 53%. The RVEDV is 90 ml (normal range 142+/-31), RV end diastolic volume index is 42 ml/m2 (normal range 82+/-16), the RVESV is 48 ml (normal range 54+/-17), and the RV end systolic volume index is 22 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal sized.Aortic ValveThe aortic valve is trileaflet, 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 drain normally into the right atrium.PericardiumThere is a moderate sized pericardial effusion, likely loculated in the inferior aspect of the pericardium. There is likely pericardial enhancement with associated mild thickening. Probable adhesions are noted at least within the anterior and left lateral aspects of the pericardium.Extracardiac FindingsLarge bilateral pleural effusions. 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. Findings suggestive of pericardial constriction: Mild pericardial thickening and enhancement, likely loculated inferior pericardial effusion, intraventricular dependence, and probable pericardial adhesions. 2. Normal Left ventricle size and function at 57%. Normal RV size with low normal ejection fraction.3. Large bilateral pleural effusions. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.