MRI CARD WWO CNTRST, VIABLTY/SCAR IMAG.MORPH/FUNCT, 9/15/2016 4:35 PM Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 44%. The LVEDV is 134 ml (normal range 142+/-34), the LV end diastolic volume index is 63 ml/m2 (normal range: 74+/-15), the LVESV is 78 ml (normal range 47+/-19) and the LV end systolic volume index is 35 ml/m2 (normal range 25+/-9). Sigmoid septum present. There are regional wall motion abnormalities present in 3 discrete areas of myocardium. There is akinesis of the apical inferior wall with transmural enhancement suggesting non-viability. There is hypokinesis of the mid inferolateral wall with < 50% transmural enhancement suggesting viability. Lastly there is a subendocardial 50% transmural enhancement in the mid-distal anterior wall. While all these segments are c/w an ischemic etiology, they clearly represent discrete vascular territories. There is no LV thrombus. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 44%. The RVEDV is 132 ml (normal range 142+/-31), RV end diastolic volume index is 60 ml/m2 (normal range 82+/-16), the RVESV is 75 ml (normal range 54+/-17), and the RV end systolic volume index is 34 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 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 dilated.Venous AnatomyThe SVC and IVC drain normally into the right atrium. There is a catheter in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsChest wall artifact from pacer device. 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.Normal LV size with mildly reduced systolic function (LVEF 44%).2.Normal RV size with mildly reduced systolic function (RVEF(44%).3.There are regional wall motion abnormalities present in 3 discrete areas of myocardium. There is akinesis of the apical inferior wall with transmural enhancement suggesting non-viability. There is hypokinesis of the mid inferolateral wall with < 50% transmural enhancement suggesting viability. Lastly there is a subendocardial 50% transmural enhancement in the mid-distal anterior wall. While all these segments are c/w an ischemic etiology, they clearly represent discrete vascular territories. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.