81 year old man with multiple myeloma, referred for evaluation of cardiac amyloid. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 109 ml/m2 (normal range: 74+/-15), the LVEDV is 202 ml (normal range 142+/-34), the LV end systolic volume index is 41 ml/m2 (normal range 25+/-9), the LVESV is 75 ml (normal range 47+/-19), the LV mass index is 59 g/m2 (normal range 85+/-15), and the LV mass is 108 g (normal range 164+/-36). There are no regional wall motion abnormalities present. The native myocardial T1 relaxation time is 1007ms, which is in the normal range. 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. There is lipomatous hypertrophy of the interatrial septum. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 65%, the RV end diastolic volume index is 88 ml/m2 (normal range 82+/-16), the RVEDV is 163 ml (normal range 142+/-31), the RV end systolic volume index is 30 ml/m2 (normal range 31+/-9), and the RVESV is 56 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is moderate 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 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 mildly dilated.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsDiffuse interstitial disease is noted in the bilateral lung fields . Small T2 hyperintense splenic lesions, possibly sarcoid-related. 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 with normal systolic function. The overall LV ejection fraction is 63%.2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The native myocardial T1 relaxation time is 1007ms, which is in the normal range. Given these findings, there is currently no imaging evidence suggestive of cardiac amyloid.3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 65%