48 year old female with a history of congenital pulmonary stenosis s/p PVR with pulmonic insufficiency and known pulmonary artery aneurysm. She is now referred for cardiac assessment and follow-up of pulmonary artery dimensions. Height: 170cmLeft VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is63%, the LV end diastolic volume index is 76 ml/m2 (normal range: 65+/-11), the LVEDV is 177 ml (normal range 109+/-23), the LV end systolic volume index is 27 ml/m2 (normal range 18+/-5), the LVESV is 67 ml (normal range 31+/-10), the LV mass index is 44 g/m2 (normal range 67+/-11), and the LV mass is 101g (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 mildly dilated with normal systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 98 ml/m2 (normal range 69+/-14), the RVEDV is 228 ml (normal range 110+/-24), the RV end systolic volume index is 45 ml/m2 (normal range 22+/-8), and the RVESV is 105 ml (normal range 35+/-13). Right AtriumThe right atrium is severely dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and visually there is trace mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. Pulmonic regurgitation appears at least moderate, but stable when compared to previous MRI. Tricuspid ValveThe tricuspid valve opens widely. Visually 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. There is no thoracic aortic aneurysm. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is severely dilated. Measurements using 3D volumetric data demonstrate the following:Proximal main PA: 33x33mmDistal main PA: 45mmx43mmLeft PA (proximal): 35x44mmLeft PA (distal): 36x36mmRight PA: 34x33mmThese values are stable when compared to previously obtained measurements. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac Findings 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. Normal left ventricular size and systolic function (LVEF 63%).2. Mildly dilated right ventricular size and normal systolic function (RVEF 54%).3. Moderate pulmonary valve regurgitation (visual estimate).4. Severely dilated right atrium.6. Pulmonary artery dilation which is severe, with measurements stable when compared to the previous MRI of 2014.