47 year old woman with history of NSVT and concern for ARVD, referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. There is a subtle wall motion abnormality involving the basal to mid anterolateral wall. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 91 ml/m2 (normal range: 65+/-11), the LVEDV is 184 ml (normal range 109+/-23), the LV end systolic volume index is 36 ml/m2 (normal range 18+/-5), the LVESV is 72 ml (normal range 31+/-10), the LV mass index is 19 g/m2 (normal range 67+/-11), and the LV mass is 38 g (normal range 114+/-24). There is an atypical pattern of late gadolinium enhancement involving the midwall of the basal anterolateral segment and also the epicardium of the basal to mid inferior and inferoseptal walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is not consistent with prior myocardial infarction. 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 60%, the RV end diastolic volume index is 73 ml/m2 (normal range 69+/-14), the RVEDV is 148 ml (normal range 110+/-24), the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8), and the RVESV is 60 ml (normal range 35+/-13). There are no regional or focal RV wall motion abnormalities present.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 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 normal in size with normal systolic function. The overall LV ejection fraction is 61%. There is a subtle wall motion abnormality involving the basal to mid anterolateral walls. There is an atypical pattern of late gadolinium enhancement involving the midwall of the basal anterolateral segment and also the epicardium of the basal to mid inferior and inferoseptal walls suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process such as old myocarditis, sarcoidosis, etc. The pattern is not consistent with prior myocardial infarction. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 60%. There are no regional wall motion abnormalities present. There is no cardiac MRI evidence to support the diagnosis of arrhythmogenic right ventricular cardiomyopathy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.