59 year old female with a history of biopsy proven amyloidosis referred for cardiovascular MRI to evaluate for cardiac involvement. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 67%, the LV end diastolic volume index is 84 ml/m2 (normal range: 65+/-11), the LVEDV is 135 ml (normal range 109+/-23), the LV end systolic volume index is 28 ml/m2 (normal range 18+/-5), the LVESV is 44 ml (normal range 31+/-10), the LV mass index is 73 g/m2 (normal range 67+/-11), and the LV mass is 117 g (normal range 114+/-24). There are no regional wall motion abnormalities present. Late gadolinium kinetics are abnormal on the TI scout images (50 msec between cavity and myocardial nulling). There are several areas of abnormal Gd uptake in a patchy pattern involving the basal inferior and posterior wall and IVS. Left AtriumThe left atrium is dilated.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 67%, the RV end diastolic volume index is 75 ml/m2 (normal range 69+/-14), the RVEDV is 120 ml (normal range 110+/-24), the RV end systolic volume index is 25 ml/m2 (normal range 22+/-8), and the RVESV is 39 ml (normal range 35+/-13). 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 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. Abnormal Gd kinetic and patches of late Gd enhancement c/w cardiac amyloid.2. Compared to 1-2014 Gd enhancement appears similar.