A 53 year old male with history of heart, kidney and pancreas transplant in 2006. Referred to cardiac MRI to evaluate rejection. Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 73%, the LV end diastolic volume index is 73 ml/m2 (normal range: 74+/-15), the LVEDV is 149 ml (normal range 142+/-34), the LV end systolic volume index is 19 ml/m2 (normal range 25+/-9), the LVESV is 39 ml (normal range 47+/-19), the LV mass index is 60 g/m2 (normal range 85+/-15), and the LV mass is 124 g (normal range 164+/-36). 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.The GRE (global relative enhancement) value is normal (1.90).The T2 STIR ER (edema ratio) value is normal (1.70).The EVF (extracellular volume fraction is above normal (36.6%).No intracardiac 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 61%, the RV end diastolic volume index is 82 ml/m2 (normal range 82+/-16), the RVEDV is 169 ml (normal range 142+/-31), the RV end systolic volume index is 31 ml/m2 (normal range 31+/-9), and the RVESV is 64 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.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 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 are normal in size and drain normally into the right atrium.PericardiumThere is no pericardial effusion.Extracardiac FindingsSternal wires were noted. Bilateral pleural effusions, mild on the right and trace on the left. Rounded atelectasis at the posterior basal segment right lower lobe. Postsurgical findings compatible with cardiac transplant.
1. The left ventricle is normal in size with hyperdynamic systolic function, the LVEF is 73%. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The GRE (global relative enhancement) value is normal (1.90). The T2 STIR ER (edema ratio) value is normal (1.70). The EVF (extracellular volume fraction is above normal (36.6%). These findings are basal numbers for future follow up.4. No findings that support heart transplant rejection.5. The left atrium is mildly dilated. 6. The right ventricle is normal in size with normal systolic function, the RVEF is 61%.7. Mild tricuspid regurgitation.