26 year old male with a history of non-ischemic cardiomyopathy status-post heart transplant in 11/2016 with a history of pericarditis now with persistently elevated white blood cell count and ECG changes. He is referred for cardiac MRI. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 70%, the LV end diastolic volume index is 72 ml/m2 (normal range: 74+/-15), the LVEDV is 164 ml (normal range 142+/-34), the LV end systolic volume index is 21 ml/m2 (normal range 25+/-9), the LVESV is 48 ml (normal range 47+/-19).There are no regional wall motion abnormalities present.. There is a focus of late gadolinium enhancement of the distal inferior/inferolateral wall that is not typical for infarction and may suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pre-contrast native myocardial T1 relaxation times are normal. Left AtriumThe left atrium is consistent with transplant. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 66%, the RV end diastolic volume index is 72 ml/m2 (normal range 82+/-16), the RVEDV is 162 ml (normal range 142+/-31), the RV end systolic volume index is 25 ml/m2 (normal range 31+/-9), and the RVESV is 55 ml (normal range 54+/-17).Right AtriumThe right atrium is consistent with transplant.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 normal in size.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.PericardiumThere is a small pericardial effusion. The pericardium is upper normal in thickness. There is late gadolinium enhancement of the pericardium. Extracardiac FindingsSternal wires present. There is a right sided pleural effusion. 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. The overall LV ejection fraction is 70%.There are no regional wall motion abnormalities present.. There is a focus of late gadolinium enhancement of the distal inferior/inferolateral wall that is not typical for infarction and may suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pre-contrast native myocardial T1 relaxation times are normal. 2.The right ventricle is normal in size and systolic function. The overall RV ejection fraction is 66%.3. There is a small pericardial effusion. The pericardium is upper normal in thickness. There is late gadolinium enhancement of the pericardium consistent with inflammation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.