58 year old female with non small cell lung cancer with new mass seen on the atrial septum on TTE. She also has shortness of breath and chest pain. MRI evaluation for atrial septal mass. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 56%. The LVEDV is 73 ml (normal range 109+/-23), LV end diastolic volume index is 45 ml/m2 (normal range: 65+/-11), LVESV is 18 ml (normal range 31+/-10), and LV end systolic volume index is 11 ml/m2 (normal range 18+/-5). 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.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 53%, the RV end diastolic volume index is 62 ml/m2 (normal range 69+/-14), the RVEDV is 101 ml (normal range 110+/-24), the RV end systolic volume index is 29 ml/m2 (normal range 22+/-8), and the RVESV is 46 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsPulmonary veins drain normally into the left atrium, LUPV poorly visualized.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is a small pericardial effusion.Extracardiac FindingsThere is a large right sided pleural effusion. There is also a large loculated fluid collection at the left lung base. Extensive L lung changes c/w recent CT (post surgical, radiation changes)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.Normal sized left ventricle with normal systolic function.2.Normal sized right ventricle with normal systolic function.3.Large right sided pleural effusion. 4.Large loculated fluid collection at the left lung base. 5.No intracardiac mass to explain PET uptake at the aortic root / interatrial septum6.Posterior extracardiac mass noted on TTE is a large loculated L pleural effusion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.