54 year old male with a history of hypothyroidism, non-ischemic dilated cardiomyopathy with new left bundle branch block now referred for repeat cardiac MRI. Left VentricleThe left ventricle is moderately dilated with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 127 ml/m2 (normal range: 74+/-15), the LVEDV is 268 ml (normal range 142+/-34), the LV end systolic volume index is 70 ml/m2 (normal range 25+/-9), the LVESV is 148 ml (normal range 47+/-19), the LV mass index is 62 g/m2, and the LV mass is 131 g. As seen on the previous study there is a persistent small area of late gadolinium enhancement in the basal inferior and inferolateral walls, atypical for prior myocardial infarction and suggests the presence of an underlying myocardial infiltrative, inflammatory, or fibrotic process. There is no myocardial iron overload. There is abnormal septal motion consistent with known conduction abnormality.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is moderately dilated with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 134 ml/m2 (normal range 82+/-16), the RVEDV is 285 ml (normal range 142+/-31), the RV end systolic volume index is 67 ml/m2 (normal range 31+/-9), and the RVESV is 143 ml (normal range 54+/-17).Right AtriumThe right atrium is moderate-severely dilated. Aortic ValveThe aortic valve opens widely and there is trivial aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild 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 a trivial pericardial effusionExtracardiac FindingsMultiple hepatic cysts or hemangiomas are noted. 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. Moderately dilated LV with mildly reduced systolic function (EF 45%). The ventricle is more dilated with slightly worse systolic function when compared to the previous study. 2. Moderately dilated RV with mildly reduced systolic function (EF 50%), essentially stable from previous.3. Unchanged area of late gadolinium enhancement in the basal inferolateral wall which is suggestive of inflammatory, infiltrative or fibrotic process. The pattern is atypical for prior myocardial infarction.4. Biatrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.