A 49 year old male with history of sickle cell disease including avascular necrosis, s/p bilateral hip replacement and high transfusion burden. A recent echocardiography study showed moderately reduces systolic function. Referred to cardiac MRI to evaluate cardiac function Left VentricleThe left ventricle is dilated with moderately reduced systolic function. The overall LV ejection fraction is 39%, the LV end diastolic volume index is 171 ml/m2 (normal range: 74+/-15), the LVEDV is 276 ml (normal range 142+/-34), the LV end systolic volume index is 105 ml/m2 (normal range 25+/-9), the LVESV is 169 ml (normal range 47+/-19), the LV mass index is 100 g/m2 (normal range 85+/-15), and the LV mass is 161 g (normal range 164+/-36). There is antero-septal and infero-septal hypokinesis at the base and middle segments. There is septal bounce. There is late gadolinium enhancement at the basal segment of the anterior wall. This finding suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No intracavitary thrombus.No myocardial iron overload (T2-star above 30ms).Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 105 ml/m2 (normal range 82+/-16), the RVEDV is 170 ml (normal range 142+/-31), the RV end systolic volume index is 57 ml/m2 (normal range 31+/-9), and the RVESV is 92 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately 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 trace pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is moderately dilated in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumSmall amount of pericardial fluid.Extracardiac FindingsIron overload was noted in the liver (T2-star around 5ms). The spleen also appears more hypointense than the liver suggesting iron infiltration. Probable small left renal cyst. 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 significantly dilated with moderately reduced systolic function, the LVEF is 39%. There is antero-septal and infero-septal hypokinesis at the base and middle segments. There is septal bounce. 2. There is late gadolinium enhancement at the basal segment of the anterior wall. This finding suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. No myocardial iron overload (T2-star above 30ms).4. The right ventricle is normal in size with mildly reduced systolic function, the RVEF is 46%. 5. The left and right atriums are moderately dilated.6. Iron overload was noted in the liver (T2-star around 5ms) with probable associated iron overload in the spleen, consistent with secondary hemochromatosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.