69 year old female referred for cardiac MRI to evaluate aortic valve insufficiency. Left VentricleThe left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 46%, the LV end diastolic volume index is 132 ml/m2 (normal range: 65+/-11), the LVEDV is 258 ml (normal range 109+/-23), the LV end systolic volume index is 72 ml/m2 (normal range 18+/-5), the LVESV is 140 ml (normal range 31+/-10), the LV mass index is 61 g/m2 (normal range 67+/-11), and the LV mass is 118 g (normal range 114+/-24). 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.No intracardiac thrombus.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with normal sysolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 80 ml/m2 (normal range 69+/-14), the RVEDV is 156 ml (normal range 110+/-24), the RV end systolic volume index is 40 ml/m2 (normal range 22+/-8), and the RVESV is 78 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveTrileaflet aortic valve with thickened leaflets and moderate calcification. Leaflet motion is mildly restricted. Dedicated through-plane imaging demonstrated moderate aortic regurgitation from the central coaptation site with regurgitant fraction 32%. Forward flow is 119 mL, regurgitant volume is 38 mL. Effective orifice area is normal, at 2.8 cm2. Mitral ValveThe mitral valve opens widely and there is mitral regurgitation, visually estimated to be mild. Mitral valve leaflets appear mildly thickened. Dedicated through-plane imaging was not performed. 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 mildly dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no pericardial effusion.Extracardiac FindingsLeft subscapluar intramuscular lipoma.
1. Thickened and calcified trileaflet aortic valve with moderate aortic regurgitation, quantified as 32%)2. Severely dilated left ventricle with mildly reduced systolic function (LVEF 46%)3. Normal right ventricular size and systolic function.4. Severe left atrial dilation.5. Mitral regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.