46 year old woman referred for further evaluation of RA mass. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 85 ml/m2 (normal range: 65+/-11), the LVEDV is 194 ml (normal range 109+/-23), the LV end systolic volume index is 32 ml/m2 (normal range 18+/-5), the LVESV is 72 ml (normal range 31+/-10), the LV mass index is 47 g/m2 (normal range 67+/-11), and the LV mass is 107 g (normal range 114+/-24). 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.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 64%, the RV end diastolic volume index is 94 ml/m2 (normal range 69+/-14), the RVEDV is 215 ml (normal range 110+/-24), the RV end systolic volume index is 34 ml/m2 (normal range 22+/-8), and the RVESV is 79 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. There are a small nodule appearing mass attached to the RA side of the interatrial septum, adjacent to the fossa ovalis near the IVC, It measures about 7x7mm and does not appear to be highly vascular nor have late gadolinium enhancement. There is additionally no increased signal intensity on T1 and hypointensity on T2. Overall they do not have features concerning for a malignant process. Based on the location, I would suspect that the mass represents remnant tissue from atrial septal embryogenesis; however, repeat imaging to demonstrate stability would be reassuring.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 normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsMild lymphadenopathy in bilateral axilla (all <1cm). 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 overall LV ejection fraction is 63%. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 64%.3. There is a small nodular mass located adjacent to the fossa ovalis near the IVC of unclear etiology. Its morphologic appearance does not appear malignant. Based on the location, it may represent remnant tissue from atrial embryogenesis; however, demonstration of stability on repeat imaging would prove to be reassuring.4. Mild biatrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.