80-year-old male with history of COPD, CKD, DM with lung nodules and mediastinal lymphadenopathy concerning for sarcoidosis vs lymphoma. Referred for cardiac MRI to evaluate for possible cardiac sarcoid. Left VentricleThe left ventricle is normal in size with normal systolic function. There is no LV hypertrophy. The overall LV ejection fraction is 58%. The LVEDV is 171 ml (normal range 142+/-34), the LV end diastolic volume index is 68 ml/m2 (normal range: 74+/-15), the LVESV is 71 ml (normal range 47+/-19) and the LV end systolic volume index is 28 ml/m2 (normal range 25+/-9). The LV mass is 112 g (normal range 164+/-36) and the LV mass index is 44 g/m2 (normal range 85+/-15). No evidence of inflammation/edema of the myocardium on T2 STIR images. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.There is no LV thrombus. Left AtriumThe left atrium is mildly dilated. Lipomatous inter-atrial septum.Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 50%. The RVEDV is 219 ml (normal range 142+/-31), RV end diastolic volume index is 86 ml/m2 (normal range 82+/-16), the RVESV is 108 ml (normal range 54+/-17), and the RV end systolic volume index is 43 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve is trileaflet, opens widely and there is trivial aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild 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 thickening and prominence of the pericardial sac. On T2 STIR images there is notable hyperintensity of the pericardium. This is suggestive of underlying edema/inflammation of the pericardium and is consistent with pericarditis. There is also trace pericardial effusion.Extracardiac FindingsMediastinal adenopathy. Axillary nodes also noted in the left axillae. 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 normal in size with normal systolic function. The overall LV ejection fraction is 58%. No evidence of inflammation/edema of the myocardium on T2 STIR images. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2.The right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 50%.3.There is thickening and prominence of the pericardial sac. On T2 STIR images there is notable hyperintensity of the pericardium. This is suggestive of underlying edema/inflammation of the pericardium and is consistent with pericarditis. There is also trace pericardial effusion.4.Lipomatous inter-atrial septum.5.See extra-cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.