16 year-old female with systemic lupus and nephritis. History of elevated cardiac enzymes and chest pain.Referred for CMR to rule out myocardits Left VentricleThe left ventricle is mild-moderately dilated with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 108 ml/m2 (normal range: 65+/-11), the LVEDV is 202 ml (normal range 109+/-23), the LV end systolic volume index is 45 ml/m2 (normal range 18+/-5), the LVESV is 84 ml (normal range 31+/-10), the LV mass index is 67 g/m2 (normal range 67+/-11), and the LV mass is 126 g (normal range 114+/-24). There are no regional wall motion abnormalities present. T2 Stir images show evidence of edema/inflammation in the region of e lateral/antero-lateral wall which is suggestive of an acute inflammatory process such as myocarditis There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Myocardial T1 time ~1150 ms which is abnormal and could be consistent with diffuse fibrosis.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 107 ml/m2 (normal range 69+/-14), the RVEDV is 200 ml (normal range 110+/-24), the RV end systolic volume index is 47 ml/m2 (normal range 22+/-8), and the RVESV is 89 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is at least mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild-moderate 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. PericardiumSmall pericardial effusion. Bright pericardium noted on T2-stir images suggestive of pericarditis.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 mild-moderately dilated with normal systolic function. The overall LV ejection fraction is 59%. There are no regional wall motion abnormalities present. T2 Stir images show evidence of edema/inflammation in the region of e lateral/antero-lateral wall which is suggestive of an acute inflammatory process such as myocarditis There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Myocardial T1 time ~1150 ms which is abnormal and could be consistent with diffuse fibrosis.2. The right ventricle is mildly dilated. The overall RV ejection fraction is 56%3. Small pericardial effusion. Hyperenhancement on T2-stir images suggestive of pericardits4. At least mild aortic regurgitation and mid-moderate tricuspid regurgitation. 5. This constellation of findings is consistent with myo-pericarditis.