72 y/o male with systemic amyloidosis, diastolic dysfunction, ESRD, multiple myeloma, HTN and HLD. Patient is referred for MRI evaluation pre-inguinal hernia repair. Left VentricleThe left ventricle is normal in size and systolic function. There is mild concentric left ventricular hypertrophy (IVSd=12 mm; previously 14mm). The overall LV ejection fraction is 64%. The LVEDV is 110 ml (normal range 142+/-34), the LV end diastolic volume index is 52 ml/m2 (normal range: 74+/-15), the LVESV is 39 ml (normal range 47+/-19) and the LV end systolic volume index is 19 ml/m2 (normal range 25+/-9). The LV mass is 95 g (normal range 164+/-36) and the LV mass index is 45 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. The native T1 myocardial relaxation times are 1100 ms in the left ventricular lateral wall and 1157 ms in the interventricular septum. These values are elevated and consistent with his diagnosis of suspected cardiac amyloidosis and have improved from his previous cardiac MRI 9/25/2015 (1215 ms).There is no myocardial iron overload. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size. The overall RV ejection fraction is 52%. The RVEDV is 157 ml (normal range 142+/-31), RV end diastolic volume index is 75 ml/m2 (normal range 82+/-16), the RVESV is 76 ml (normal range 54+/-17), and the RV end systolic volume index is 36 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is severely dilated.Aortic ValveThe aortic valve is trileaflet and opens widely. 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-moderate regurgitation.AortaThere is a left sided aortic arch with a pseudobovine 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 (30.7 mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. A catheter is noted in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere is a large right sided pleural effusion. 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, LVEF 64%. Mild left ventricular hypertrophy. LV wall thickness and native myocardial T1 have improved when compared to the previous cardiac MRI of 2015.2. Normal RV size with mildly reduced systolic function, RVEF 52%.3. Biatrial dilatation. 4. Large right pleural effusion. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.