49 year old man with cryptogenic cirrhosis and possible cardiomyopathy here for cardiac MRI evaluation. 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 94 ml/m2 (normal range: 74+/-15), the LVEDV is 168 ml (normal range 142+/-34), the LV end systolic volume index is 27 ml/m2 (normal range 25+/-9), the LVESV is 48 ml (normal range 47+/-19), the LV mass index is 34 g/m2 (normal range 85+/-15), and the LV mass is 60 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of a focal underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is mildly elevated at 1110ms, which is mildly elevated. This could suggest an underlying diffuse myocardial infiltrative or fibrotic process. Gadolinium kinetics are not consistent with cardiac amyloidosis.There is no myocardial iron overload. Left AtriumThe left atrium is mild-moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 65%, the RV end diastolic volume index is 85 ml/m2 (normal range 82+/-16), the RVEDV is 153 ml (normal range 142+/-31), the RV end systolic volume index is 30 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. The sinus of Valsalva measures upper normal (35mm).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 FindingsRecanalization of the umbilical vein consistent with elevated portal pressures. Nodular contour of liver consistent with cirrhosis. Splenomegaly. Extensive peri-gastric varices. Ascites is present. 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 size left ventricle with hyperdynamic systolic function (EF 72%). There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is mildly elevated at 1110ms. 2. Normal size right ventricle with normal systolic function (EF 65%.)3. Biatrial enlargement.4. Findings consistent with cirrhosis. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.