61 year old woman with new aortic dilation and aortic regurgitation seen on echo, referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 122 ml/m2 (normal range: 65+/-11), the LVEDV is 220 ml (normal range 109+/-23), the LV end systolic volume index is 54 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10). 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.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 63%, the RV end diastolic volume index is 65 ml/m2 (normal range 69+/-14), the RVEDV is 117 ml (normal range 110+/-24), the RV end systolic volume index is 24 ml/m2 (normal range 22+/-8), and the RVESV is 43 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and is tri-leaflet. There is moderate aortic regurgitation (regurgitant fraction 36%) that is eccentrically directed towards the anterior mitral valve leaflet. The AR regurgitant jet appears to be centrally located.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. No thoracic aortic dissection is noted. The thoracic aorta has minimal tortuosity. No aortic coarctation is noted. Aortic dimensions are as below:Sinus of Valsalva: 40mm x 41mm x 42mmSinotubular Junction: 42mm x 40mmAscending Aorta (4cm from annulus): 43mm x 44mmProximal Aortic Arch (proximal to innominate artery): 43mm x 40mmMid Aortic Arch: 31mm x 30mmDescending Aorta: 27mm x 27mmPulmonary 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. Moderate dilation of the ascending aorta (dimensions described above). SOV measurement z-score is 3.62. The aortic valve opens widely and is tri-leaflet. There is moderate aortic regurgitation (regurgitant fraction 36%) that is centrally located.3. The left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 56%.4. The right ventricle is normal in size with normal systolic function.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.