67 year old woman with history of LV dysfunction and eosinophilia, with previous cardiac biopsy suggestive of eosinophilic myocarditis. She was referred for cardiac MRI to evaluate for scar and active inflammation in view of recent steroid wean and intermittent symptoms of fatigue. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 50%, the LVEDV is 152 ml (normal range 109+/-23), the LV end diastolic volume index is 80 ml/m2 (normal range: 65+/-11), the LVESV is 75 ml (normal range 31+/-10), the LV end systolic volume index is 40 ml/m2 (normal range 18+/-5), the LV mass is 85 g (normal range 114+/-24), and the LV mass index is 45 g/m2 (normal range 67+/-11). There is global mild hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No LV thrombus. 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 59%, the RVEDV is 137 ml (normal range 110+/-24), the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVESV is 56 ml (normal range 35+/-13), and the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation. Mitral ValveThe mitral valve opens widely and there is trivial mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. Aortic sinus of valsalva measures 41 x 39 x 38 mm which is similar to the previous study.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 drain normally into the right atrium. PericardiumThere is trivial pericardial effusion. On T2 STIR images there is prominence of the pericardial sac that could suggest evidence of pericardial inflammation. This prominence of the pericardial sac was also seen on previous study.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 no longer dilated but still shows mildly reduced systolic function (LV EF 50%). This has improved from previous LVEF 46%2. No late gadolinium enhancement to suggest an infiltrative, inflammatory or fibrotic process. 3. Normal size right ventricle with normal systolic function (EF 59%).4. There is trivial pericardial effusion. On T2 STIR images there is prominence of the pericardial sac that could suggest evidence of pericardial inflammation. This prominence of the pericardial sac was also seen on previous study.5. See aortic measurements above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.