72 year old man non ischemic cardiomyopathy referred for cardiac MRI for further evaluation of underlying etiology. Left VentricleThe left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 33%, the LV end diastolic volume index is 141 ml/m2 (normal range: 74+/-15), the LVEDV is 303 ml (normal range 142+/-34), the LV end systolic volume index is 93 ml/m2 (normal range 25+/-9), the LVESV is 199 ml (normal range 47+/-19), the LV mass index is 66 g/m2 (normal range 85+/-15), and the LV mass is 142 g (normal range 164+/-36). LV dysfunction is global with regional variation. There is mid-myocardial pattern of late gadolinium enhancement in the basal inferior and inferolateral walls that is not in a typical infarct pattern and suggests the presence of underlying myocardial fibrosing, infiltrative, or inflammatory process. The pattern is not suggestive of prior myocardial infarction or amyloidosis. There is also no evidence of myocardial iron overload. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 81 ml/m2 (normal range 82+/-16), the RVEDV is 176 ml (normal range 142+/-31), the RV end systolic volume index is 35 ml/m2 (normal range 31+/-9), and the RVESV is 75 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild 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 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. The left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 33%. LV dysfunction is global with regional variation.2. There is mid-myocardial pattern of late gadolinium enhancement in the basal inferior and inferolateral walls that is not typical for myocardial infarction and suggests the presence of underlying myocardial fibrosing, infiltrative, or inflammatory process. 3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%.4. Significant bi-atrial enlargement.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.