70 year old man with multiple myeloma, referred for evaluation of cardiac amyloid. Left VentricleThe left ventricle is mildly dilated with normal systolic function. The overall LV ejection fraction is 62%, the LV end diastolic volume index is 112 ml/m2 (normal range: 74+/-15), the LVEDV is 254 ml (normal range 142+/-34), the LV end systolic volume index is 42 ml/m2 (normal range 25+/-9), the LVESV is 96 ml (normal range 47+/-19). There is mild concentric LVH (IVSd 12mm). There are no regional wall motion abnormalities present. There is late gadolinium enhancement in the lateral walls that is atypical for infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. It appears similar to LGE on prior cardiac MRI on 10/16/15. There is a small area of delayed enhancement in the inferoseptum suggestive of "RV insertion" point enhancement. The basal IVS native myocardial T1 time is 1006ms and the basal inferolateral T1 time is 1080ms (decreased from prior MRI).Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 89 ml/m2 (normal range 82+/-16), the RVEDV is 200 ml (normal range 142+/-31), the RV end systolic volume index is 44 ml/m2 (normal range 31+/-9), and the RVESV is 98 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trace 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 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 mildly dilated with normal systolic function. The overall LV ejection fraction is 62%.2. There is late gadolinium enhancement in the lateral walls that is atypical for infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. It appears similar to LGE on prior cardiac MRI on 10/16/15. The basal IVS native myocardial T1 time is 1006ms and the basal inferolateral T1 time is 1080ms (decreased from prior MRI).3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%. 4. Compared to prior MRI on 10/16/15, the LGE pattern visually appears similar, however the native T1 times have decreased.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.