42 year old male with a history of traumatic pericardial effusion, pericarditis referred for cardiac MRI for constriction. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 46%, the LV end diastolic volume index is 108 ml/m2 (normal range: 74+/-15), the LVEDV is 240 ml (normal range 142+/-34), the LV end systolic volume index is 57 ml/m2 (normal range 25+/-9), the LVESV is 128 ml (normal range 47+/-19), the LV mass index is 31 g/m2 (normal range 85+/-15), and the LV mass is 69 g (normal range 164+/-36). There is global hypokinesis There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pre-contrast native myocardial T1 relaxation time is normal (~1030 ms). Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 91 ml/m2 (normal range 82+/-16), the RVEDV is 199 ml (normal range 142+/-31), the RV end systolic volume index is 48 ml/m2 (normal range 31+/-9), and the RVESV is 106 ml (normal range 54+/-17).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 at least mild 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 pseudo-bovine aortic arch. 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.PericardiumSmall pericardial effusion some of which does not appear to be free-flowing. There is thickening of the pericardium. There is hyperenhancement of the pericardial sac on T2-Stir imaging suggestive of inflammatory process of the pericardium. There is evidence of pericardial late gadolinium enhancement. There is evidence of mild respirophasic septal shift during free breathing which is consistent with constrictive physiology. With tagged imaging there is a suggestion of tethering of the pericardium.Extracardiac FindingsSmall left pleural effusion with left lower lobe atelectasis. 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 mildly reduced systolic function (LVEF 46%).2. The right ventricle is normal in size with mildly reduced systolic function (RVEF 47%). 3. Small pericardial effusion some of which does not appear to be free-flowing. 4. Evidence of acute pericarditis with thickening of the pericardium. There is hyperenhancement of the pericardial sac on T2-Stir imaging suggestive of an acute inflammatory process of the pericardium. There is also evidence of pericardial late gadolinium enhancement. 5. Mild respirophasic septal shift during free breathing which is consistent with constrictive physiology.Tagged imaging suggestion possible tethering of the pericardium. 6. This constellation of findings are consistent with acute pericarditis with possible early pericardial constrictive physiology. Follow-up and clinical correlation suggested.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.