59 year old female with a history of recurrent syncope and ventricular dilation noted on echocardiogram. She is referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is mildly dilated with systolic function. The overall LV ejection fraction is 57%, the LV end diastolic volume index is 91 ml/m2 (normal range: 65+/-11), the LVEDV is 141 ml (normal range 109+/-23), the LV end systolic volume index is 39 ml/m2 (normal range 18+/-5), the LVESV is 60 ml (normal range 31+/-10), the LV mass index is 26 g/m2 (normal range 67+/-11), and the LV mass is 40 g (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. There is an imaging artifact noted on late gadolinium enhancement images in the basal inferolateral wall. There is no evidence of myocardial iron overload. The pre-contrast native myocardial T1 relaxation time is normal (980 ms). Left AtriumThe left atrium is normal in size (75ml). No atrial septal defect noted. Right VentricleThe right ventricle is upper limits of normal size with normal systolic function. The overall RV ejection fraction is 53%. There is no focal aneurysm or wall motion abnormalities of the RV. The RV end diastolic volume index is 93 ml/m2 (normal range 69+/-14), the RVEDV is 144 ml (normal range 110+/-24), the RV end systolic volume index is 43 ml/m2 (normal range 22+/-8), and the RVESV is 67 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Dilated coronary sinus suggesting increased right atrial pressure. Aortic ValveThe aortic valve opens widely and there is mild 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 mild to 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. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsStomach is air-filled. 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 mildly dilated with systolic function (LVEF 57%) without evidence of late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process2. The right ventricle is upper limits of normal size with normal systolic function (RVEF 53%). There is no focal aneurysm or wall motion abnormalities of the RV to suggest arrhythmogenic right ventricular cardiomyopathy. 3. Moderate right atrial enlargement and dilated coronary sinus. 4. Mild aortic regurgitation5. Mild to moderate tricuspid regurgitation. 6. Extra-cardiac findings as described above. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.