65 year old woman referred for cardiac MRI imaging prior to atrial fibrillation ablation. Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 64 ml/m2 (normal range: 65+/-11), the LVEDV is 151 ml (normal range 109+/-23), the LV end systolic volume index is 30 ml/m2 (normal range 18+/-5), the LVESV is 72 ml (normal range 31+/-10), the LV mass index is 37 g/m2 (normal range 67+/-11), and the LV mass is 86 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is a patchy pattern of late gadolinium enhancement involving the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The LGE does involve the subendocardium so prior myocardial infarction can not be excluded. Left AtriumThe left atrium is severely dilated. The LA volume is 243 ml. There is no obvious left atrial appendage thrombus.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 81 ml/m2 (normal range 69+/-14), the RVEDV is 192 ml (normal range 110+/-24), the RV end systolic volume index is 38 ml/m2 (normal range 22+/-8), and the RVESV is 91 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. The right atrium volume is 169 ml. Aortic ValveThe aortic valve opens widely and there is no significant 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 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. There is a very large right-sided pulmonary vein with a small right inferior pulmonary vein branching off nearly at the ostium. Dimensions as below:RUPV: 33mm x 25mmRLPV: 13mm x 9mmLUPV: 19mm x 16mmLLPV: 24mm x 20mmPulmonary 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 normal in size with low normal systolic function. The overall LV ejection fraction is 53%. There is a patchy pattern of late gadolinium enhancement involving the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The LGE does involve the subendocardium so prior myocardial infarction can not be excluded. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%.3. The left atrium is severely dilated. The LA volume is 243 ml. There is no obvious left atrial appendage thrombus. Moderate right atrial dilation.4. All four pulmonary veins drain normally into the left atrium. Dimensions as above.5. The main pulmonary artery is mildly dilated. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.