66 year old woman with history of LV dysfunction and eosinophilia, with previous cardiac biopsy suggestive of eosinophilic myocarditis. She was referred for cardiac MRI to evaluate for scar and active inflammation. Left VentricleThe left ventricle is mild to moderately dilated with mildly reduced systolic function. The overall LV ejection fraction is 46%, the LV end diastolic volume index is 97 ml/m2 (normal range: 65+/-11), the LVEDV is 165 ml (normal range 109+/-23), the LV end systolic volume index is 52 ml/m2 (normal range 18+/-5), the LVESV is 89 ml (normal range 31+/-10), the LV mass index is 40 g/m2 (normal range 67+/-11), and the LV mass is 68 g (normal range 114+/-24). There is global hypokinesis. The native T1 myocardial relaxation time is borderline elevated (between 1040-1080ms). There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No LV thrombus. Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 78 ml/m2 (normal range 69+/-14), the RVEDV is 131 ml (normal range 110+/-24), the RV end systolic volume index is 39 ml/m2 (normal range 22+/-8), and the RVESV is 66 ml (normal range 35+/-13). No RV thrombus. Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trivial mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The ascending aorta measures 40mm (mildly dilated). 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 a small pericardial effusion. 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. Mild to moderately dilated left ventricle with mildly reduced systolic function (LV EF 46%).2. No late gadolinium enhancement to suggest an infiltrative, inflammatory or fibrotic process. Native myocardial T1 relaxation times are at the upper limits of normal. 3. Normal size right ventricle with normal systolic function (EF 50%).4. Mild aortic regurgitation. 5. Mild tricuspid regurgitation. 6. There is a small pericardial effusion. 7. Mild aortic root dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.