50 year-old man with non-ischemic dilated cardiomyopathy referred for MRI to evaluate possible etiologies. Left VentricleThe left ventricle is severely dilated with severe systolic dysfunction. The overall LV ejection fraction is 11%, the LV end diastolic volume index is 204 ml/m2 (normal range: 74+/-15), the LVEDV is 491 ml (normal range 142+/-34), the LV end systolic volume index is 182 ml/m2 (normal range 25+/-9), the LVESV is 438 ml (normal range 47+/-19), the LV mass index is 48 g/m2 (normal range 85+/-15), and the LV mass is 116 g (normal range 164+/-36). There is global hypokinesis with regional variation. There are patches of transmural late gadolinium enhancement at the mid inferoseptal and lateral walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. The distribution is not compatible with ischemia. No apical thrombus seen on this study.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is moderately dilated with severely reduced systolic function. The overall RV ejection fraction is 19%, the RV end diastolic volume index is 140 ml/m2 (normal range 82+/-16), the RVEDV is 336 ml (normal range 142+/-31), the RV end systolic volume index is 113 ml/m2 (normal range 31+/-9), and the RVESV is 272 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is severe mitral regurgitation with bileaflet teeteringPulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least moderate 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 moderate to severely dilated.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsMultiple pulmonary nodules noted. These are better described on recent CT. 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 severely dilated with severe systolic dysfunction. The overall LV ejection fraction is 11%. There are patches of transmural late gadolinium enhancement at the mid inferoseptal and lateral walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. The distribution is not compatible with ischemia.2. The right ventricle is moderately dilated with severely reduced systolic function. The overall RV ejection fraction is 19%3. There is severe mitral regurgitation4. There is at least moderate tricuspid regurgitation.5. Moderate-severely dilated main pulmonary artery6. See extra-cardiac findings.All LGE images not available for review. Will add addendum if new findings seen.