14 year old female with congenital pulmonary stenosis s/p balloon valvuloplasty. Referred for research cardiovascular MRI to evaluate right ventricular volume and function. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 81 ml/m2 (normal range: 65+/-11), the LVEDV is 133 ml (normal range 109+/-23), the LV end systolic volume index is 30 ml/m2 (normal range 18+/-5), the LVESV is 49 ml (normal range 31+/-10), the LV mass index is 18 g/m2 (normal range 67+/-11), and the LV mass is 78 g (normal range 114+/-24). There are no regional wall motion abnormalities present. Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is severely dilated with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 183 ml/m2 (normal range 69+/-14), the RVEDV is 299 ml (normal range 110+/-24), the RV end systolic volume index is 87 ml/m2 (normal range 22+/-8), and the RVESV is 141 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. 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 is thickened but opens widely. There is severe pulmonic regurgitation, and no stenosis.Pulmonary valve regurgitant fraction is 41%Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a pseudo-bovine brachiocephalic branching pattern. The aortic root is normal in sizePulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteriesThe main pulmonary artery is hyper-pulsatile. The increases from 33mm to 43mm during the cardiac cycle. The right pulmonary artery as a diameter of 22mm and recieves approximately 60% of cardiac output The left pulmonary artery is mildly stenotic with a diameter of 17mm with evidence of flow acceleration. It receives approximately 40% of cardiac output.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is a trace pericardial effusion. Extracardiac FindingsResidual thymus tissue is noted. 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.
This is a limited cardiac MRI without contrast performed for research purposes. The following observations are made.1. Severely dilated right ventricle with normal systolic function. (RVEF 53%, RVEDV indexed 183 mL/m2)2. Severe pulmonary valve insufficiency.3. Significant dilation of the main pulmonary artery with evidence of mild left pulmonary artery stenosis.4. Normal left ventricular size and systolic function (LVEF 63%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.