30 year old with history of acute myocarditis in December 2014, and PVCs on holter monitor. Referred for cardiac MRI to re-evaluate late gadolinium enhancement. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 57 ml/m2 (normal range: 74+/-15), the LVEDV is 104 ml (normal range 142+/-34), the LV end systolic volume index is 22 ml/m2 (normal range 25+/-9), the LVESV is 41 ml (normal range 47+/-19), the LV mass index is 44 g/m2 (normal range 85+/-15), and the LV mass is 80 g (normal range 164+/-36). There are no regional wall motion abnormalities present. T-1 weighted early gadolinium enhancement imaging showed no abnormality. There is epicardial delayed gadolinium enhancement in the basal inferior and inferolateral segments which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction.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 56%, the RV end diastolic volume index is 64 ml/m2 (normal range 82+/-16), the RVEDV is 115 ml (normal range 142+/-31), the RV end systolic volume index is 28 ml/m2 (normal range 31+/-9), and the RVESV is 51 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 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. Normal left ventricular size and systolic function (LVEF 61%).2. Normal right ventricular size and systolic function (RVEF 56%).3. T-1 weighted early gadolinium enhancement imaging showed no abnormality. There is epicardial delayed gadolinium enhancement in the basal inferior and inferolateral segments which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction.4. Compared to the prior MRI 1-2015, the post contrast T1 image abnormality has resolved, but the delayed enhancement persists in the same myocardial segments (lateral and inferolateral). This is consistent with healed, but no longer active, myocarditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.