40 year old man with cutaneous amyloidosis, hypertension referred for cardiac MRI to evaluate for potential amyloid involvement of the heart. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 69%, the LV end diastolic volume index is 64 ml/m2 (normal range: 74+/-15), the LVEDV is 130 ml (normal range 142+/-34), the LV end systolic volume index is 20 ml/m2 (normal range 25+/-9), the LVESV is 40 ml (normal range 47+/-19), the LV mass index is 55 g/m2 (normal range 85+/-15), and the LV mass is 111 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Gadolinium kinetics appear normal. The native T1 myocardial relaxation time in the basal, mid and apical septum is within normal limits (920-940ms).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 60%, the RV end diastolic volume index is 69 ml/m2 (normal range 82+/-16), the RVEDV is 140 ml (normal range 142+/-31), the RV end systolic volume index is 28 ml/m2 (normal range 31+/-9), and the RVESV is 56 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 are normal drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsRight hemidiaphragm elevation 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. The left ventricle is normal in size with normal systolic function (EF 69%). The left ventricular function is more vigorous on today's study. There is no abnormal late gadolinium enhancement to suggest the presence of cardiac amyloidosis. Furthermore, the native T1 myocardial relaxation times are within normal limits. 2. Normal size right ventricle with normal systolic function (EF 60%).3. Unusually elevated right hemidiaphragm. Correlate with concern for diaphragmatic dysfunction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.