40 year old male with Crohn's disease, s/p collectomy, atrial flutter after ablation and after cardiac arrest post-cardioversion presenting for follow up MRI for ventricular function and scar evaluation. Left VentricleThe left ventricle is mildly dilated with moderately reduced systolic. The overall LV ejection fraction is 37%, the LV end diastolic volume index is 110 ml/m2 (normal range: 74+/-15), the LVEDV is 277 ml (normal range 142+/-34), the LV end systolic volume index is 69 ml/m2 (normal range 25+/-9), the LVESV is 174 ml (normal range 47+/-19), the LV mass index is 64 g/m2 (normal range 85+/-15), and the LV mass is 160 g (normal range 164+/-36). The LV dysfunction is global with regional variation . There is mild amorphous late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process present in the anterior, septal and inferior walls as seen previously. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with moderately reduced systolic function. The overall RV ejection fraction is 32%, the RV end diastolic volume index is 128 ml/m2 (normal range 82+/-16), the RVEDV is 323 ml (normal range 142+/-31), the RV end systolic volume index is 87 ml/m2 (normal range 31+/-9), and the RVESV is 220 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly 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 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 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. The left ventricle is mildly dilated with moderately reduced systolic. The overall LV ejection fraction is 37%. The LV dysfunction is global with regional variation. There is mild amorphous late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process present in the anterior, septal and inferior walls as seen previously. 2. The right ventricle is mildly dilated with moderately reduced systolic function. The overall RV ejection fraction is 32%.Compared to 11/18/15 CMR, the LGE pattern and LV/RV function appears similar and compared to CMR of 8/7/2015 the RV/LV function is clearly better. 