A 66 year old male with paroxysmal atrial fibrillation, increased CPK extra-cardiac sarcoidosis with suspected cardiac involvement from previous cardiac MRI in 2009. Referred now to cardiac MRI for follow up. Left VentricleThe left ventricle remains normal in size and systolic function. The overall LV ejection fraction is 58%. There are no regional wall motion abnormalities present. The previous left ventricular ejection fraction was 59%. There is mild progression of basal anteroseptal hypertrophy measuring up to 14 mm. The LV end diastolic volume index is 84 ml/m2 (normal range: 74+/-15), the LVEDV is 185 ml (normal range 142+/-34), the LV end systolic volume index is 35 ml/m2 (normal range 25+/-9), the LVESV is 77 ml (normal range 47+/-19), the LV mass index is 43 g/m2 (normal range 85+/-15), and the LV mass is 93 g (normal range 164+/-36). There is late gadolinium enhancement in the basal infero-lateral segment in a mid myocardial distribution, similar in extent to the cardiac MRI of 2009. The late gadolinium enhancement spares the endocardium. Given the clinical history, this is suggestive of myocardial sarcoidosis. No thrombus is present.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 96 ml/m2 (normal range 82+/-16), the RVEDV is 210 ml (normal range 142+/-31), the RV end systolic volume index is 47 ml/m2 (normal range 31+/-9), and the RVESV is 102 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly 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. There is mild chordal systolic anterior motion during systole secondary to anterobasal septal hypertrophy.Pulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is tricuspid regurgitation which visually appears mild. Dedicated imaging was not performed.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 no pericardial effusion.Extracardiac FindingsMild bilateral hilar lymphadenopathy.
1. Well-preserved left ventricular function with an LVEF of 58%.2. Enhancement at the basal infero-lateral segment similar to cardiac MRI of 2009. This spares the endocardium and is not likely to represent a prior myocardial infarction. Given the clinical history, this is suggestive of cardiac sarcoidosis. There is no significant changes compared to 2009.3. The right ventricle is normal in size and systolic function, the RVEF is 51%. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.