A 68 year old female with known multiple myeloma and systemic amyloid with echocardiography that showed normal left ventricular function, borderline LVH and diastolic dysfunction. Referred to cardiac MRI to assess possible cardiac amyloid. Left VentricleThe left ventricle is normal in size and systolic function. Based on myocardial tagging, there is normal deformation of the myocardium. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 75 ml/m2 (normal range: 65+/-11), the LVEDV is 116 ml (normal range 109+/-23), the LV end systolic volume index is 34 ml/m2 (normal range 18+/-5), the LVESV is 53 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 77 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is mild left ventricular hypertrophy (IVSd=11mm). There is a myocardial diverticulum or alternatively a spontaneously healed muscular VSD noted in the interventricular septum.The native myocardial T1 value is 1050ms, which is near the normal range and does not support the diagnosis of cardiac amyloidosis.Based on T2-star imaging, there is no evidence of myocardial iron overload. Left AtriumThe left atrium is mildly dilated.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVEDV is 113 ml (normal range 110+/-24), the RV end systolic volume index is 34 ml/m2 (normal range 22+/-8), and the RVESV is 54 ml (normal range 35+/-13). 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 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 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 FindingsIron overload was noted in the liver and spleen (T2-star=5msec). 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 and systolic function (LVEF 54%). There are no regional wall motion abnormalities present. The wall thickness is mildly increased. Native T1-mapping and T2-star imaging do not support the diagnosis of cardiac amyloidosis or myocardial iron overload. 2. The right ventricle is normal in size and systolic function (RVEF 52%).3. The left atrium is mildly dilated.4. Mild dilation of the main pulmonary artery. 5. Iron overload was noted in the liver and spleen.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.