76 year old female with a remote history of breast cancer, active colon cancer undergoing treatment referred for cardiac MRI after abnormal echocardiogram (apex with unclear clot/mass limited by poor acoustic windows). Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 58%, the LV end diastolic volume index is 79 ml/m2 (normal range: 65+/-11), the LVEDV is 139 ml (normal range 109+/-23), the LV end systolic volume index is 33 ml/m2 (normal range 18+/-5), the LVESV is 58 ml (normal range 31+/-10). There is thinning of apical myocardium, is a small symmetric distribution, which likely represents a normal variant. There is sigmoid septum (normal variant). There is abnormal motion of the interventricular septum of unclear significance. There is late non-transmural gadolinium enhancement of the mid anterolateral wall that may represent previous myocardial infarction. Less likely is inflammation or infiltrative disease. There is no thrombus or mass noted in the apex. The pre-contrast native myocardial relaxation T1 times of the myocardial septum is normal (965 ms). There is no evidence of iron overload. Left AtriumThe left atrium is normal in size. Interatrial septal aneurysm.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVEDV is 127 ml (normal range 110+/-24), the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8), and the RVESV is 53 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 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 mildly dilated. 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 drain normally into the right atrium. There is a mass in the SVC - likely catheter but a catheter related thrombus can not be excluded.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 and systolic function (LVEF 58%).2. The right ventricle is normal in size and systolic function (RVEF 58%). 3. There is late non-transmural gadolinium of the mid anterolateral wall that may represent previous myocardial infarction. Less likely is inflammation or infiltrative disease.5. There is no thrombus noted in the apex. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.