17 year old male with recent diagnosis of myopericarditis referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 68 ml/m2 (normal range: 74+/-15), the LVEDV is 144 ml (normal range 142+/-34), the LV end systolic volume index is 25 ml/m2 (normal range 25+/-9), the LVESV is 53 ml (normal range 47+/-19), the LV mass index is 45 g/m2 (normal range 85+/-15), and the LV mass is 96 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is a significant amount of epicardial late gadolinium enhancement along the basal and apical inferior and inferolateral walls which is atypical for myocardial infarction and rather suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is commonly described in myocarditis. There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 78 ml/m2 (normal range 82+/-16), the RVEDV is 167 ml (normal range 142+/-31), the RV end systolic volume index is 33 ml/m2 (normal range 31+/-9), and the RVESV is 70 ml (normal range 54+/-17).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 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 drain normally into the right atrium.PericardiumThere is a trivial pericardial effusion. There is no significant pericardial thickening or inflammation noted.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. Normal size left ventricle with normal systolic function (EF 63%). 2. There is a significant amount epicardial late gadolinium enhancement in the basal and apical inferior and inferolateral wall which is atypical for previous myocardial infarction and suggests underlying infiltrative, inflammatory or fibrotic disease. The pattern is highly consistent with the diagnosis of myocarditis. 3. Normal size right ventricle with normal systolic function (EF 58%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.