68 year old woman with history of lung cancer s/p resection, pulmonary arterial hypertension, and aortic regurgitation referred for cardiac MRI to serially evaluate cardiac function and valvular disease. Left VentricleThe left ventricle is qualitative normal in size and systolic function. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is qualitatively moderate to severely dilated with preserved systolic function. Right AtriumThe right atrium is severely dilated. Aortic ValveThe aortic valve is trileaflet and opens widely. There is mild aortic regurgitation. Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation. There is mild thickening of the leaflet tips.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is severe tricuspid regurgitation which appears more prominent than on the previous MRI.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern, though the overall course of the aorta is deviated towards the left hemithorax.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated. The main PA size is 28 x 29 mm, the right PA size is 23x19 mm, and the left PA size is 21x22 mm. The left PA ends in a blind pouch.Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is no pericardial effusion.Extracardiac FindingsAs noted on previous studies, due to prior lung resection the cardiac structures are significantly deviated into the left hemithorax. There is associated mediastial/tracheal deviation to the left. There is a 19 x 16mm ovoid mass in the liver which has been visualized on previous abdominal imaging and is stable in size compared to the previous MRI. 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 LV size and systolic function without evidence of underlying myocardial fibrosis, inflammation, or infiltration. 2. Moderate to severe RV dilation with preserved systolic function.3. Severe right atrial dilation.4. Severe tricuspid regurgitation. 5. See extra-cardiac findings.6. Quantitative software not currently available. Addendum to be added to reports once quantification can be performed.7. When compared to study from 7/17/2015, the tricuspid regurgitation is a little worse. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.