16 year old male with history of recent myocarditis and clinical VT, with recurrent arrhythmias now referred for repeat cardiac MR to evaluate scar burden and function. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 73 ml/m2 (normal range: 74+/-15), the LVEDV is 146 ml (normal range 142+/-34), the LV end systolic volume index is 29 ml/m2 (normal range 25+/-9), the LVESV is 57 ml (normal range 47+/-19), the LV mass index is 43 g/m2 (normal range 85+/-15), and the LV mass is 87 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is persistence of epicardial late gadolinium enhancement in the basal anterolateral and small segment of the mid inferolateral walls, but overall there is less myocardial involvement on this study. This pattern of late gadolinium enhancement is typical for prior myocarditis. The T2-STIR signal in the inferolateral and lateral walls seen on the previous study suggesting myocardial edema are no longer present; additionally the global relative enhancement ratio is normal.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 79 ml/m2 (normal range 82+/-16), the RVEDV is 158 ml (normal range 142+/-31), the RV end systolic volume index is 40 ml/m2 (normal range 31+/-9), and the RVESV is 80 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 are normal in size and drain normally into the right atrium.PericardiumThere is no significant pericardial disease noted.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. Normal size left ventricle with normal systolic function (EF 61%), which is improved when compared to the prior study. LV diastolic volumes are similar to the previous study.2. There is persistence of epicardial late gadolinium enhancement in the basal anterolateral and small segment of the mid inferolateral walls, but overall there is less myocardial involvement on this study. 3. Normal size RV with normal systolic function (EF 50%).