51 year old male with post operative LV dysfunction after liver transplant in June 2016. MRI for evaluation of possible cause. Left VentricleThe left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 46%. The LVEDV is 258 ml (normal range 142+/-34), the LV end diastolic volume index is 144 ml/m2 (normal range: 74+/-15), the LVESV is 139 ml (normal range 47+/-19) and the LV end systolic volume index is 78 ml/m2 (normal range 25+/-9). The LV mass is 154 g (normal range 164+/-36) and the LV mass index is 86 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is 1100-1125 ms which is mildly elevated and can represent the presence of underlying myocardial interstitial fibrosis or edema.There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is severely enlarged. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 54%. The RVEDV is 224 ml (normal range 142+/-31), RV end diastolic volume index is 125 ml/m2 (normal range 82+/-16), the RVESV is 103 ml (normal range 54+/-17), and the RV end systolic volume index is 58 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild 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 normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is a small pericardial effusion.Extracardiac FindingsThere are bilateral moderate sized pleural effusions.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.Severe left ventricular dilation with mildly reduced systolic function (LVEF 46%). There is no evidence of myocardial scar/ replacement fibrosis or infiltration based on late gadolinium enhancement; however, the native myocardial T1 relaxation time was mildly elevated suggesting the presence of underlying myocardial interstitial fibrosis or edema). 2.Mildly dilated right ventricle with normal systolic function (RVEF 54%). 3.Severely enlarged left atrium4.Bilateral moderate sized pleural effusions5.Small pericardial effusion. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.