66 year old man with cardiac amyloid, referred for interval assessment of disease burden. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 70 ml/m2 (normal range: 74+/-15), the LVEDV is 152 ml (normal range 142+/-34), the LV end systolic volume index is 27 ml/m2 (normal range 25+/-9), the LVESV is 60 ml (normal range 47+/-19), the LV mass index is 56 g/m2 (normal range 85+/-15), and the LV mass is 122 g (normal range 164+/-36). There is normal wall thickness (IVS=10mm). There are no regional wall motion abnormalities present. There is a small area of intra-myocardial late gadolinium enhancement in the basal inferolateral wall that is not typical of an infarct and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. It appears similar to findings on prior CMR. The native myocardial T1 time in the basal inferolateral wall is 1135ms (mildly elevated) and in the interventricular septum is 1086ms (borderline). The T1 time in the inferolateral wall is mildly elevated, correlating with LGE findings. TI scout continues to have normal gadolinium "kinetics."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 66%, the RV end diastolic volume index is 72 ml/m2 (normal range 82+/-16), the RVEDV is 157 ml (normal range 142+/-31), the RV end systolic volume index is 25 ml/m2 (normal range 31+/-9), and the RVESV is 54 ml (normal range 54+/-17).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.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 in size and 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 LV size, wall thickness, and systolic function (LVEF 61%) with atypical late gadolinium enhancement in the basal inferolateral wall. No change when compared to prior study. 2. Native myocardial T1 times are borderline elevated in the interventricular septum and mildly elevated in the basal inferolateral wall. 3. Normal RV size and systolic function (RVEF 66%). I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.