58 year old woman with history of ILD pulmonary fibrosis on oxygen who presents for cardiac MRI for further evaluation of right heart size and function 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 49 ml/m2 (normal range: 65+/-11), the LVEDV is 105 ml (normal range 109+/-23), the LV end systolic volume index is 21 ml/m2 (normal range 18+/-5), the LVESV is 45 ml (normal range 31+/-10), the LV mass index is 35 g/m2 (normal range 67+/-11), and the LV mass is 75 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement (LGE) to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. There is an area of increased signal on the LGE images in the basal inferolateral wall, which most likely represents an imaging artifact. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 62 ml/m2 (normal range 69+/-14), the RVEDV is 133 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 72 ml (normal range 35+/-13). No evidence of RV insertion point late gadolinium enhancement. AtriaMild left atrial dilation. The right atrium is mildly increased. The interatrial septum is aneurysmal. No evidence of atrial septal defect. 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 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 mildly dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSevere right hemi-diaphragmatic elevation. Consolidation/ atelectasis of bilateral lower lungs. 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. The left ventricle is normal in size and systolic function[LVEF 58%]2. The right ventricle is normal in size with mildly reduced systolic function [RVEF 46%]. RV/LV volume ratio is 1.3. No evidence of RV insertion point late gadolinium enhancement. 3. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.4. Mild biatrial dilation with an aneurysmal interatrial septum. 5. Mild dilation of the main pulmonary artery dilation. 6. Extra-cardiac findings as aboveI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.