31 year old male with history of sickle cell anemia who presents for cardiac MRI for evaluation of shortness of breath and abnormal ECHO at OSH Left VentricleThe left ventricle is severely dilated with normal systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 172 ml/m2 (normal range: 74+/-15), the LVEDV is 335 ml (normal range 142+/-34), the LV end systolic volume index is 75 ml/m2 (normal range 25+/-9), the LVESV is 147 ml (normal range 47+/-19), the LV mass index is 101 g/m2 (normal range 85+/-15), and the LV mass is 198 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.There is no evidence of iron overload in the myocardium.Left AtriumThe left atrium is moderately dilated in size. Right VentricleThe right ventricle is severely dilated and normal in systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 172 ml/m2 (normal range 82+/-16), the RVEDV is 335 ml (normal range 142+/-31), the RV end systolic volume index is 75 ml/m2 (normal range 31+/-9), and the RVESV is 147 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated 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 are normal in size and drain normally into the right atrium.PericardiumThere is a moderate to large amount of pericardial effusion without evidence of hemodynamic compromise.Extracardiac FindingsThere is evidence of iron overload in the liver (T2-star = 6ms). There are small bilateral nodules present in the lung fields in addition to bilateral 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 severely dilated with normal systolic function (LVEF 56%)2. The right ventricle is severely dilated and normal in systolic function (RVEF 53%)3. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.4. There is no evidence of iron overload in the myocardium. However, there is iron overload present in the liver.6. Moderate biatrial dilation7. Moderate to large pericardial effusion8. In comparison to the cardiac MRI dated 12/15/2009, there is no longer evidence of LGE on this scan. The size of the pericardial effusion is slightly decreased in size. 