47 year old male with history of CML with possible intracardiac mass seen on transthoracic echocardiogram. Cardiac MRI done to further evaluate character of possible mass. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 66 %, the LV end diastolic volume index is 72 ml/m2 (normal range: 74+/-15), the LVEDV is 220 ml (normal range 142+/-34), the LV end systolic volume index is 24 ml/m2 (normal range 25+/-9), the LVESV is 75 ml (normal range 47+/-19), the LV mass index is 57 g/m2 (normal range 85+/-15), and the LV mass is 172 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.There is a 4 x10 mm, mass that appears on the basal lateral wall just below the posterior leaflet of the mitral valve. The mass is likely adherent to the myocardium and appears to extend out onto the basal portion of the MV posterior leaflet. The mass does not appear to be cystic and is not composed of fat. There is no late gadolinium enhancement of the mass and has vascularity similar to the myocardium.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 55 %, the RV end diastolic volume index is 87 ml/m2 (normal range 82+/-16), the RVEDV is 268 ml (normal range 142+/-31), the RV end systolic volume index is 39 ml/m2 (normal range 31+/-9), and the RVESV is 121 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 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 drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere are trace bilateral pleural effusions. Splenomegaly is noted. 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 normal in size and systolic function (LVEF 66%)2. The right ventricle is normal in size and systolic function (RVEF 55%)3.There is a 4 x10 mm, mass that appears on the basal lateral wall just below the posterior leaflet of the mitral valve. The mass is likely adherent to the myocardium and appears to extend out onto the basal portion of the MV posterior leaflet. The mass does not appear to be cystic and is not composed of fat. There is no late gadolinium enhancement of the mass and it has vascularity similar to the myocardium, which suggests it is not thrombus. Its location is atypical for vegetation. Mitral annular calcification can present in this way, however there are no clinical predispositions to this (age, ESRD etc). Prior chest imaging (CT or MRI) or prior TTE may be helpful to review if available.