16 year old woman with history of suspected myocarditis with previous LV dysfunction and PVCs, now referred for repeat cardiac MRI to evaluate function and for evidence of inflammation. 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 108 ml/m2 (normal range: 65+/-11), the LVEDV is 172 ml (normal range 109+/-23), the LV end systolic volume index is 44 ml/m2 (normal range 18+/-5), the LVESV is 71 ml (normal range 31+/-10), the LV mass index is 59 g/m2 (normal range 67+/-11), and the LV mass is 94 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is a persistent small focus of late gadolinium enhancement in the mid chamber of the left ventricle at the inferior insertion point the right ventricle which could suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This is in the same location as was seen on the previous cardiac MRI. There is no myocardial edema. Left AtriumThe left atrium is normal size. Right VentricleThe right ventricle is moderately dilated with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 125 ml/m2 (normal range 69+/-14), the RVEDV is 199 ml (normal range 110+/-24), the RV end systolic volume index is 67 ml/m2 (normal range 22+/-8), and the RVESV is 108 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. 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 are normal in size and drain normally into the right atrium. PericardiumThere is no pericardial effusion, thickening or edema present.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. Normal size left ventricle with normal systolic function (EF 59%), which is improved from the prior MRI exam. 2. Small focus of late gadolinium enhancement in the mid chamber of the left ventricle at the inferior RV insertion point; this is stable compared to the prior exam. 3. Moderately dilated right ventricle with mildly reduced systolic function (EF 46%). While the function has improved, the RV remains dilated. Given the patient's history of ventricular ectopy, consider further dedicated RV imaging for ARVC if clinically indicated.4. Right atrium mildly dilated. 