50 year old female with non-ischemic cardiomyopathy, severe MR, COPD referred for cardiac MRI. Left VentricleThe left ventricle is severely dilated and moderately reduced systolic function. The overall LV ejection fraction is 34%, the LV end diastolic volume index is 185 ml/m2 (normal range: 65+/-11), the LVEDV is 215 ml (normal range 109+/-23), the LV end systolic volume index is 121 ml/m2 (normal range 18+/-5), the LVESV is 142 ml (normal range 31+/-10), the LV mass index is 45 g/m2 (normal range 67+/-11), and the LV mass is 53 g (normal range 114+/-24). There is global hypokinesis with regional variation. There is no definitive late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The myocardial T1 relaxation time ranges from 1020-1050 ms which is within normal limits. There is no evidence of myocardial iron overload. No evidence of left ventricular thrombus. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is moderately dilated with severely reduced systolic function. The overall RV ejection fraction is 25%, the RV end diastolic volume index is 115 ml/m2 (normal range 69+/-14), the RVEDV is 134 ml (normal range 110+/-24), the RV end systolic volume index is 86 ml/m2 (normal range 22+/-8), and the RVESV is 100 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve is thickened. There is bileaflet tethering of the mitral valve. There is moderate to severe mitral regurgitation. 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 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 FindingsOne 7mm mediastinal lymph node (likely calcified) is noted above right pulmonary artery. This 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 severely dilated and moderately reduced systolic function (LVEF 34%). There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2.The right ventricle is moderately dilated with severely reduced systolic function (RVEF 25%).3.The mitral valve is thickened. There is bileaflet tethering and moderate to severe mitral regurgitation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.