41 year old female with non-ischemic cardiomyopathy, SLE, HTN, history of nephrotic syndrome and depression, history of low EF, now with fatigue. MRI to evaluate cardiac function. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 44%. The LVEDV is 181 ml (normal range 109+/-23), LV end diastolic volume index is 95 ml/m2 (normal range: 65+/-11), LVESV is 102 ml (normal range 31+/-10), and LV end systolic volume index is 53 ml/m2 (normal range 18+/-5). The LV mass is 161 g (normal range 114+/-24) and the LV mass index is 84 g/m2 (normal range 67+/-11). There is hypokinesis of the inferolateral wall in the mid chamber. There is late gadolinium enhancement in the basal and mid ventricular inferoseptal and inferolateral walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time in the septum is 1098 ms which is at the high end of normal. The T1 myocardial relaxation time in the area of the late gadolinium enhancement is 1490 ms which is significantly elevated. These values are suggestive of some underlying diffuse fibrosis or infiltration. There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is mildly dilated.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 124 ml/m2 (normal range 69+/-14), the RVEDV is 65 ml (normal range 110+/-24), the RV end systolic volume index is 59 ml/m2 (normal range 22+/-8), and the RVESV is 31 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve is thickened at the leaflet tips but opens widely and there is at least mild 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 normal in size. Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is a small pericardial effusion.Extracardiac FindingsTrace pleural effusion. 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.Late gadolinium enhancement in the basal and mid ventricular inferoseptal and inferolateral walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process.2.Native T1 myocardial relaxation time in the IVS is 1098 ms which is at the high end of normal. 3.T1 myocardial relaxation time in the area of LGE is 1490 ms which is significantly elevated and suggestive of some underlying diffuse fibrosis or infiltration. 4.Mildly dilated left ventricle with mildly reduced systolic function.5.Normal sized right ventricle with normal systolic function.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.