60 year old female with multiorgan involvement with AL amyloidosis, referred for surveillance cardiac MRI. Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 72%, the LV end diastolic volume index is 74 ml/m2 (normal range: 65+/-11), the LVEDV is 118 ml (normal range 109+/-23), the LV end systolic volume index is 20 ml/m2 (normal range 18+/-5), the LVESV is 33 ml (normal range 31+/-10), the LV mass index is elevated at 97 g/m2 (normal range 67+/-11), with an LV mass of 155 g (normal range 114+/-24). There is concentric left ventricular hypertrophy: the maximal thickness is at the basal anterior wall of 15-16 mm, marginally greater than noted on the previous MRI. There are no regional wall motion abnormalities. There is relatively diffuse subendocardial late gadolinium enhancement involving the majority of the left ventricle, which appears grossly unchanged. The native T1 myocardial relaxation times remain elevated (1180-1220ms in the basal septum.)Left AtriumThe left atrium is moderately dilated. The interatrial septum is thickened.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 69%, the RV end diastolic volume index is 71 ml/m2 (normal range 69+/-14), the RVEDV is 114 ml (normal range 110+/-24), the RV end systolic volume index is 22 ml/m2 (normal range 22+/-8), and the RVESV is 36 ml (normal range 35+/-13). There appears to be late gadolinium enhancement involving the RV free wall which was not evident on the previous study.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. The leaflet tips are thickened.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.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. There is a catheter in the SVC.PericardiumThere is a small pericardial effusion.Extracardiac FindingsMild to moderate thoracolumbar disc degeneration. 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 hyperdynamic systolic function, the LVEF is 72%. There is concentric left ventricular hypertrophy: the maximal thickness is at the basal anterior wall of 15-16 mm, marginally greater than noted on the previous MRI. There is relatively diffuse subendocardial late gadolinium enhancement involving the majority of the left ventricle, which appears grossly unchanged. The native T1 myocardial relaxation times remain elevated (1180-1220ms in the basal septum.). 3. The right ventricle is normal in size with normal systolic function, the RVEF is 69%. There appears to be late gadolinium enhancement involving the RV free wall when compared to the previous study. 4. There is biatrial dilatation. 5. There is a catheter in the SVC.6. There is a small pericardial effusion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.