47 year old woman with recent diagnosis of diffuse large B-cell lymphoma, family history of coronary disease, found to have reduced LV function on pre-chemotherapy echocardiography. She was referred for cardiac stress MR to evaluate for possible etiologies of her cardiomyopathy.MEDICATIONS: albuterol, Zyrtec, multivitamin First Pass PerfusionDuring hyperemia, no perfusion defects were present.Viability/ Myocardial ScarThere is a small amount of epicardial late gadolinium enhancement involving the basal inferolateral wall which is atypical for myocardial infarction and suggests prior fibrosis, inflammation, or infiltration. The remainder of the myocardium is viable.Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 50%, the LV end diastolic volume index is 81 ml/m2 (normal range: 65+/-11), the LVEDV is 171 ml (normal range 109+/-23), the LV end systolic volume index is 43 ml/m2 (normal range 18+/-5), the LVESV is 85 ml (normal range 31+/-10), the LV mass index is 21 g/m2, and the LV mass is 45 g. There is global hypokinesis.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 63 ml/m2 (normal range 69+/-14), the RVEDV is 131 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 62 ml (normal range 35+/-13). Right AtriumThe right atrium is mild-moderately 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 right chest wall port with catheter in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac Findings 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. No perfusion defects/ "ischemia" present during hyperemia.2. There is a small amount of epicardial late gadolinium enhancement involving the basal inferolateral wall which is atypical for myocardial infarction and suggests prior fibrosis, inflammation, or infiltration.3. Normal LV size and low normal systolic function (LVEF 50%).4. Normal RV size and mildly reduced systolic function (RVEF 47%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.