A 60 year old female with systemic amyloidosis involving the gastrointestinal tract, the heart and possibly the nervous system. about 1 year ago finished the chemotherapy and the cardiac MRI after this treatment showed improvement in some parameters. Now referred to another cardiac MRI for follow up after suspicion of progression of the disease Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 70%, the LV end diastolic volume index is 88 ml/m2 (normal range: 65+/-11), the LVEDV is 141 ml (normal range 109+/-23), the LV end systolic volume index is 27 ml/m2 (normal range 18+/-5), the LVESV is 43 ml (normal range 31+/-10), the LV mass index is 72 g/m2 (normal range 67+/-11), and the LV mass is 115 g (normal range 114+/-24). There is concentric left ventricular hypertrophy: the maximal thickness is at the basal anterior wall of about 15 mm, similar to the last cardiac MRI (1/29/2015). No definite regional wall motion abnormality. Delayed hyperenhancement has improved since previous study. There is still mild patchy delayed hyperenhancement involving the basal and mid anterior, anterolateral, and lateral walls. The T1-mapping times are still increased above 1150-1250 ms.No myocardial iron overload was noted.No intracavitary thrombus was noted.Left AtriumThe left atrium is moderately dilated. .Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 64%, the RV end diastolic volume index is 86 ml/m2 (normal range 69+/-14), the RVEDV is 137 ml (normal range 110+/-24), the RV end systolic volume index is 31 ml/m2 (normal range 22+/-8), and the RVESV is 49 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. 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.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.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. There is a catheter in the SVC.PericardiumThere is trace pericardial effusion.Extracardiac FindingsMild to moderate thoracolumbar disc degeneration. 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 hyperdynamic systolic function, the LVEF is 70%. There is concentric left ventricular hypertrophy: the maximal thickness is at the basal anterior wall of about 15 mm, similar to the last cardiac MRI (1/29/2015).2. Delayed hyperenhancement has improved since previous study. There is still mild patchy delayed hyperenhancement involving the basal and mid anterior, anterolateral, and lateral walls. The T1-mapping times are still increased above 1150-1250 ms. 3. The right ventricle is normal in size with normal systolic function, the RVEF is 64%.4. There is biatrial dilatation. 5. There is a catheter in the SVC.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.