68 year old man with significant burden of ventricular ectopy, referred for cardiac MRI for evaluation of possible underlying myocardial scar prior to EP study/ablation. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 115 ml/m2 (normal range: 74+/-15), the LVEDV is 280 ml (normal range 142+/-34), the LV end systolic volume index is 63 ml/m2 (normal range 25+/-9), the LVESV is 153 ml (normal range 47+/-19), the LV mass index is 62 g/m2 (normal range 85+/-15), and the LV mass is 151 g (normal range 164+/-36). LV dysfunction is global. There are 2 distinct regions of late gadolinium enhancement in a pattern that is atypical for prior myocardial infarction suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is mid-wall late gadolinium enhancement and involves the basal inferolateral wall and the basal anteroseptum. This pattern has frequently been described in old myocarditis, but can represent other non-ischemic etiologies as well. Left AtriumThe left atrium is mildly dilated. 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 109 ml/m2 (normal range 82+/-16), the RVEDV is 265 ml (normal range 142+/-31), the RV end systolic volume index is 58 ml/m2 (normal range 31+/-9), and the RVESV is 140 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 mildly dilated.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 mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 45%.2. There are 2 distinct regions of late gadolinium enhancement in a pattern that is atypical for prior myocardial infarction suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is mid-wall and involves the basal inferolateral wall and the basal anteroseptum and has frequently been described in old myocarditis, but can represent other non-ischemic etiologies as well. 3. The right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 47%.4. Mild dilation of the main pulmonary artery.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.