53 year old female admitted with worsening dyspnea. Has known extrapulmonary sarcoid, pulmonary hypertension and RV dysfunction. MRI done to evaluate for cardiac sarcoidosis. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 72%, the LV end diastolic volume index is 58 ml/m2 (normal range: 65+/-11), the LVEDV is 99 ml (normal range 109+/-23), the LV end systolic volume index is 16 ml/m2 (normal range 18+/-5), the LVESV is 27 ml (normal range 31+/-10), the LV mass index is 47 g/m2 (normal range 67+/-11), and the LV mass is 79 g (normal range 114+/-24). There are no regional wall motion abnormalities present. . No evidence of inflammation or edema on T2 STIR sequences. There is a small area of mid-myocardial/epicardial late gadolinium enhancement suggestive of an underlying fibrosing, infiltrative, or inflammatory process, located in the mid to apical inferoseptal region. This pattern is not consistent with prior myocardial infarction, but could be consistent with a history of prior myocarditis.Left AtriumThe left atrium is mildly enlarged. Right VentricleThe right ventricle is quantitatively mildly dilated, however on visual observation appears moderately dilated. The overall RV ejection fraction is 42%, the RV end diastolic volume index is 104 ml/m2 (normal range 69+/-14), the RVEDV is 176 ml (normal range 110+/-24), the RV end systolic volume index is 60 ml/m2 (normal range 22+/-8), and the RVESV is 101 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately enlarged. 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 pseudo-bovine 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 (37mm). Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsPulmonary findings as noted in CT chest done 10/7/2016. 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 and systolic function. The overall LV ejection fraction is 72%. There are no regional wall motion abnormalities present. There is a small area of mid-myocardial/epicardial late gadolinium enhancement suggestive of an underlying fibrosing, infiltrative, or inflammatory process, located in the mid to apical inferoseptal region. This pattern is not consistent with prior myocardial infarction, but could be consistent with a history of prior myocarditis. No evidence of inflammation or edema on T2 STIR sequences. No evidence of acute myocarditis or pericarditis.2. The right ventricle is quantitatively mildly dilated, however on visual observation appears moderately dilated. The overall RV ejection fraction is 42%.3. The left atrium is mildly enlarged. The right atrium is moderately enlarged. 4. The main pulmonary artery is dilated (37mm). 5. See extracardiac findings.