23 year old man who presents with recurrent pericarditis of unclear etiology, now referred for cardiac MRI. Left VentricleThe left ventricle is mildly dilated with normal systolic function. The overall LV ejection fraction is 58%, the LV end diastolic volume index is 107 ml/m2 (normal range: 74+/-15), the LVEDV is 216 ml (normal range 142+/-34), the LV end systolic volume index is 45 ml/m2 (normal range 25+/-9), the LVESV is 91 ml (normal range 47+/-19). Global relative enhancement is normal (<1). Native T1 time is between 950-990ms, which is not elevated. There are no regional wall motion abnormalities present. There is no myocardial late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory myocardial process.Left AtriumThe left atrium is normal in size . Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 107 ml/m2 (normal range 82+/-16), the RVEDV is 218 ml (normal range 142+/-31), the RV end systolic volume index is 54 ml/m2 (normal range 31+/-9), and the RVESV is 110 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve 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 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 a small-moderate pericardial effusion. There is increased signal within the pericardium on T2-STIR sequences to suggest pericardial edema. Additionally, there is late gadolinium enhancement of the visceral and parietal pericardium which is consistent with pericarditis. With free breathing sequences there is no abnormal septal motion with inspiration to suggest constrictive physiology.Extracardiac FindingsBilateral pleural effusions (left greater than right) with associated left lower lobe atelectasis. 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. Mildly dilated LV with normal systolic function (EF 58%). 2. No myocardial late gadolinium enhancement to suggest underlying inflammation, infiltration or fibrosis. Additionally, native T1 relaxation time in the myocardium is normal.3. However, there is increased signal on T2-STIR imaging of the pericardium, pericardial thickening and late gadolinium enhancement of the visceral and parietal pericardium which is suggestive of active pericarditis. 4. Normal size RV with normal systolic function (EF 50%).5. Bilateral pleural effusions. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.