50 year old man with heart transplant referred to evaluate for possible rejection. Left VentricleThe left ventricle is normal in size and systolic function. There are no regional wall motion abnormalities present. The native myocardial T1 relaxation time is significantly elevated (1195ms) but similar to the prior study. The myocardial T2 ratio is within normal limits (1.74), and a little better than before. Left AtriumThe left atrium has transplant morphology.Right VentricleThe right ventricle is normal in size and systolic functionRight AtriumThe right atrium is has transplant morphology.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.PericardiumThe pericardium is mildly thickened. The pericardial T2-signal is increased along the basal lateral wall, suggesting active inflammation and a little more than before. A small loculated pericardial effusion is noted. Extracardiac FindingsSmall left pleural effusion noted. Sternal wires noted. Gynecomastia 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. Normal LV size and systolic function with significant elevation in native myocardial T1 relaxation time but normal T2-ratio. These findings are similar to or a little better than before.2. Normal RV size and systolic function. 3. Mild pericardial thickening with evidence of active inflammation along the lateral wall, which is a little more than before. 4. See extra-cardiac findings.5. No contrast was used in this study because of renal dysfunction.6. Quantification of chamber size and function to follow as an addendum. 