54 year old male with non specific abnormal ECG. Referred for cardiac MRI to rule out HCM. Left VentricleThe left ventricle is normal in size with normal systolic function. There is focal hypertrophy along the basal anterior wall with a maximum thickness of 15mm. Although the LV apex appears hypertrophied, it is instead heavily trabeculated with normal wall thickness. The remainder of the myocardium has a wall thickness of approximately 10mm. The overall LV ejection fraction is 65%. The LVEDV is 185 ml (normal range 142+/-34), the LV end diastolic volume index is 95 ml/m2 (normal range: 74+/-15), the LVESV is 65 ml (normal range 47+/-19) and the LV end systolic volume index is 33 ml/m2 (normal range 25+/-9). The LV mass is 140 g (normal range 164+/-36) and the LV mass index is 71 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. There is a small amount of patchy late gadolinium enhancement within the hypertrophied basal anterior wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The overall burden of fibrosis is <5% of the total myocardial mass. The native T1 and T2 myocardial relaxation times are within normal limits. There is no myocardial iron overload.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 57%. The RVEDV is 193 ml (normal range 142+/-31), RV end diastolic volume index is 99 ml/m2 (normal range 82+/-16), the RVESV is 82 ml (normal range 54+/-17), and the RV end systolic volume index is 42 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is trileaflet, 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.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 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 normal in size with normal systolic function. LVEF 65%. There is a focal area of hypertrophy involving the basal anterior wall. Although the LV apex appears hypertrophied, it is instead heavily trabeculated with normal wall thickness. There is a small amount of patchy late gadolinium enhancement within the hypertrophied basal anterior wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Taken together, these findings support the diagnosis of hypertrophic cardiomyopathy. However, the differential diagnosis also includes some of the infiltrative cardiomyopathies. 2.The right ventricle is normal in size with normal systolic function. RVEF 57%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.