23 year old male with history of non-ischemic cardiomyopathy with possible findings of non-compaction on OSH imaging who presents for cardiac MRI to evaluate for etiology of cardiomyopathy and non-compaction. Left VentricleThe left ventricle is moderately enlarged and moderately reduced in systolic function. The overall LV ejection fraction is 40%, the LV end diastolic volume index is 125 ml/m2 (normal range: 74+/-15), the LVEDV is 263 ml (normal range 142+/-34), the LV end systolic volume index is 76 ml/m2 (normal range 25+/-9), the LVESV is 158 ml (normal range 47+/-19). There is hypokinesis of the apex and the distal lateral and inferior wall. There is mid-wall late gadolinium enhancement in the mid anterolateral wall. This pattern is atypical for myocardial infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.The non-compaction to compaction ratio of the left ventricle at end-diastole in the mid-anterolateral wall on short-axis imaging measures 2.3:1. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is moderately to severely dilated and moderately reduced in systolic function. The overall RV ejection fraction is 33%, the RV end diastolic volume index is 145 ml/m2 (normal range 82+/-16), the RVEDV is 304 ml (normal range 142+/-31), the RV end systolic volume index is 98 ml/m2 (normal range 31+/-9), and the RVESV is 205 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 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 in size and measures 31 mm.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis 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 moderately enlarged with moderately reduced systolic function (LVEF 40%). There is a regional wall motion abnormality.2. There is mid-wall late gadolinium enhancement in the mid anterolateral wall, suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The non-compaction to compaction ratio of the left ventricle at end-diastole in the mid-anterolateral wall on short-axis imaging measures 2.3:1. 4. The constellation of findings to include a NC:C ratio of 2.3, LV dysfunction, regional wall motion abnormality, as well as late-gadolinium enhancement supports the imaging diagnosis of non-compaction cardiomyopathy. 5. The right ventricle is moderately to severely dilated and moderately reduced in systolic function (RVEF 33%). 6. The main pulmonary artery is dilated and measures 31 mm. 