59-year-old man with nonischemic cardiomyopathy. Cardiac MRI was obtained to assess for presence of LGE. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 26%, the LV end diastolic volume index is 182 ml/m2 (normal range: 74+/-15), the LVEDV is 387 ml (normal range 142+/-34), the LV end systolic volume index is 134 ml/m2 (normal range 25+/-9), the LVESV is 285 ml (normal range 47+/-19), the LV mass index is 75 g/m2 (normal range 85+/-15), and the LV mass is 159 g (normal range 164+/-36). The basal to mid inferior and inferolateral walls are thinned and akinetic. There is basal to mid lateral and inferolateral transmural late gadolinium enhancement. These segments are not viable. Also noted are 3 small areas of patchy epicardial late gadolinium enhancement in the mid and apical anterior and anteroseptal walls, not described in the report of the previous cardiac MRI. This pattern could be consistent with healing myocarditis. However, other infiltrative, inflammatory, or fibrosing processes should also be considered. Unable to perform direct visual comparison with previous cardiac MRI as it was no longer available in the PACS system.Left AtriumThe left atrium is severely dilated .Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 40%, the RV end diastolic volume index is 77 ml/m2 (normal range 82+/-16), the RVEDV is 163 ml (normal range 142+/-31), the RV end systolic volume index is 46 ml/m2 (normal range 31+/-9), and the RVESV is 98 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve is trileaflet opens widely. There is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely. There is at least moderate mitral regurgitation visually. Pulmonic ValveThe pulmonic valve opens widely. There is trace pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left-sided aortic arch with a normal 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 no pericardial effusion.Extracardiac FindingsA previously noted anterior liver mass is seen, approximately 1.1 x 1.1cm. 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.
When compared to the previous report:1. Severely dilated left ventricle with severely reduced systolic function (EF 26%), slightly improved from previous. 2. The basal to mid inferior and inferolateral walls are thinned and akinetic. There is basal to mid lateral and inferolateral transmural late gadolinium enhancement. These segments are not viable. Also noted are 3 small areas of patchy epicardial late gadolinium enhancement in the mid and apical anterior and anteroseptal walls, not described in the report of the previous cardiac MRI. This pattern could be consistent with healing myocarditis. Unable to perform direct visual comparison with previous cardiac MRI as it was no longer available in the PACS system.3. Normal right ventricular size with mildly reduced systolic function (RVEF 40%), which is improved from the previous study.4. At least moderate mitral regurgitation.5. Small (1cm), round mass in the superior portion of liver. Consider ultrasound for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.