59 year old woman with non-ischemic cardiomyopathy, referred for further evaluation of underlying etiology. Left VentricleThe left ventricle is mildly dilated with severely reduced systolic function. The overall LV ejection fraction is 25%, the LV end diastolic volume index is 102 ml/m2 (normal range: 65+/-11), the LVEDV is 223 ml (normal range 109+/-23), the LV end systolic volume index is 77 ml/m2 (normal range 18+/-5), the LVESV is 167 ml (normal range 31+/-10). LV dysfunction is global with regional variation. The native myocardial T1 mapping suggests abnormal myocardium in the basal inferoseptum. There is no evidence of inflammation or edema on T2 STIR and T1 BB imaging. There is late gadolinium enhancement in the basal inferoseptal and inferior walls. It is mid-myocardial in a pattern atypical for infarction and may suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is moderately dilated.Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 48%, the RV end diastolic volume index is 43 ml/m2 (normal range 69+/-14), the RVEDV is 95 ml (normal range 110+/-24), the RV end systolic volume index is 23 ml/m2 (normal range 22+/-8), and the RVESV is 49 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThere is bi-leaflet tethering of the mitral valve with at least mild MR.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild 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 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 severely reduced systolic function. The overall LV ejection fraction is 25%. 2. There is late gadolinium enhancement in the basal inferoseptal and inferior walls. It is mid-myocardial in a pattern atypical for infarction and may suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 48%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.