50 year old man with history of hypertension and severe chest pain. He is referred to rule out aortic dissection since his renal disease prevents CTA as a test. Left VentricleLeft ventricular hypertrophy is noted. LV systolic function could not be assessed. Left AtriumModerate to severe left atrial dilation. Right VentricleGrossly normal in size and systolic function. Right AtriumModerate right atrial dilation. AortaThere is a left sided aortic arch with a pseudobovine brachiocephalic branching pattern. No aortic dissection noted to the level of the renal arteries. Normal ascending aortic and aortic arch size. Mild dilation of the proximal portion portion of the descending thoracic aorta (30mm).Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe inferior vena cava is dilated suggesting increased right atrial pressure. PericardiumSmall pericardial effusion is noted. Extracardiac FindingsSmall bilateral pleural effusions. Bilateral lung opacities seen. Several lymph nodes (largest 1.3cm) noted in right-sided pretracheal location. 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. Within the limitations of a non-contrast cardiac MRI/ MRA examination, no thoracic or abdominal aortic dissection noted down to level of the renal arteries. Mild dilation of the proximal portion of descending thoracic aorta. 2. Significant left ventricular hypertrophy.3. Moderate biatrial dilation. 4. Grossly normal RV size and systolic function.5. Small pericardial effusion.6. Multiple large lymph nodes noted as above. Small bilateral pleural effusions. A significant amount of bilateral lung opacity is noted which could represent pulmonary edema or interstitial lung disease. Correlation with chest CT (ILD protocol) suggested. 