54 year old woman with history of lymphoma treated with chemotherapy, mild LV dysfunction, referred for stress cardiac MRI prior to stem cell transplant.MEDICATIONS: Allopurinol, synthroid, lisinopril First Pass PerfusionDuring hyperemia, no perfusion defects were present.Viability/ Myocardial ScarThere is no evidence of prior myocardial infarction. There is however a small amount of epicardial late gadolinium enhancement involving the basal inferior and inferolateral walls in a pattern atypical for prior myocardial infarction suggesting the presence of myocardial fibrosis, inflammation, or infiltration. Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 75 ml/m2 (normal range: 65+/-11), the LVEDV is 164 ml (normal range 109+/-23), the LV end systolic volume index is 37 ml/m2 (normal range 18+/-5), the LVESV is 81 ml (normal range 31+/-10), the LV mass index is 27 g/m2, and the LV mass is 58 g. There is subtly hypokinesis of the basal inferior wall. 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 56%, the RV end diastolic volume index is 75 ml/m2 (normal range 69+/-14), the RVEDV is 164 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 81 ml (normal range 35+/-13). 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 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.AortaThe aortic root is normal in size. There is a left sided aortic arch with a psuedo-bovine brachiocephalic branching pattern.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 trace pericardial effusion.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. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable. 3. Normal LV size with low normal systolic function (LVEF 51%). There is a small amount of epicardial late gadolinium enhancement involving the basal inferior and inferolateral walls in a pattern atypical for prior myocardial infarction suggesting the presence of myocardial fibrosis, inflammation, or infiltration. 4. Normal RV size and normal systolic function (RVEF 56%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.