A 65 year old male with multiple myeloma, chronic kidney disease and suspected amyloid was referred to cardiac MRI for further evaluation Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 97 ml/m2 (normal range: 74+/-15), the LVEDV is 223 ml (normal range 142+/-34), the LV end systolic volume index is 39 ml/m2 (normal range 25+/-9), the LVESV is 91 ml (normal range 47+/-19), the LV mass index is 79 g/m2 (normal range 85+/-15), and the LV mass is 181 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is diffused concentric hypertrophy with a maximal diameter of 23mm at the basal anterior septum. T1-mapping analysis showed ranges of times up to 1120 ms at the basal anterior septum. 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 57%, the RV end diastolic volume index is 83 ml/m2 (normal range 82+/-16), the RVEDV is 190 ml (normal range 142+/-31), the RV end systolic volume index is 36 ml/m2 (normal range 31+/-9), and the RVESV is 83 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 are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.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 normal in size with normal systolic function, the LVEF is 59%. There are no regional wall motion abnormalities present. 2. There is diffused concentric hypertrophy with a maximal diameter of 23mm at the basal anterior septum. T1-mapping analysis showed ranges of times up to 1120 ms at the basal anterior septum. Despite that this is a limited study because of the lack of contrast, there is suspicion of cardiac amyloid.3. The right ventricle is normal in size with normal systolic function, the RVEF is 57%.4. The left atrium is mildly dilated. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.