64 year old female with a history of AL Amyloidosis. She is referred for cardiac MRI to rule out cardiac involvement. Left VentricleThe left ventricle is normal in size and function. The overall LV ejection fraction is 77%, the LV end diastolic volume index is 68 ml/m2 (normal range: 65+/-11), the LVEDV is 151 ml (normal range 109+/-23), the LV end systolic volume index is 16 ml/m2 (normal range 18+/-5), the LVESV is 35 ml (normal range 31+/-10), the LV mass index is 62 g/m2 (normal range 67+/-11), and the LV mass is 139 g (normal range 114+/-24). There are no regional wall motion abnormalities present. The basal anteroseptum is 14mm, slightly increased from 11mm. Stable enhancement of the basal to mid inferior wall. No intracardiac thrombus.Left AtriumThe left atrium is dilated.Right VentricleThe right ventricle is normal in function. The overall RV ejection fraction is 69%, the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVEDV is 160 ml (normal range 110+/-24), the RV end systolic volume index is 22 ml/m2 (normal range 22+/-8), and the RVESV is 49 ml (normal range 35+/-13). Right AtriumThe right atrium is dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mitral regurgitation, estimated to be mild.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 common origin of the innominate and left common carotid arteries. The thoracic aorta 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 FindingsStable hepatic and left renal cyst. The pancreas was not included in this field of view.
1. The left ventricle is normal in size and function. There is stable enhancement of the basal to mid inferior wall, atypical for amyloid. This may be related to prior scar from myocarditis. In this clinical setting with small pericardial effusion and slight increase in wall thickness, the possibility of localized cardiac amyloid cannot be excluded.3. The right ventricle is normal in function. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.