34 year old man with history of ALL s/p chemotherapy/radiation and stem cell transplant, elevated ferritin and recent diagnosis of LV dysfunction referred for cardiac MRI to evaluate the etiology for his cardiomyopathy. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 69 ml/m2 (normal range: 74+/-15), the LVEDV is 136 ml (normal range 142+/-34), the LV end systolic volume index is 38 ml/m2 (normal range 25+/-9), the LVESV is 76 ml (normal range 47+/-19), the LV mass index is 40 g/m2 (normal range 85+/-15), and the LV mass is 80 g (normal range 164+/-36). There is global hypokinesis. The native T1 time is normal (1050ms). The ECV fraction is normal (25%). Global relative enhancement is normal. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 61 ml/m2 (normal range 82+/-16), the RVEDV is 121 ml (normal range 142+/-31), the RV end systolic volume index is 33 ml/m2 (normal range 31+/-9), and the RVESV is 65 ml (normal range 54+/-17).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.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 obvious pericardial disease.Extracardiac FindingsThere is iron overload of the liver, as suggested by a significantly reduced T2* decay time (6.1) . 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. Normal sized left ventricle with mildly reduced systolic function (EF 45%). There is global hypokinesis. 2. No evidence of late gadolinium enhancement to suggest acute myocarditis or myocardial fibrosis, inflammation, or infiltration.3. Normal sized right ventricle with mildly reduced systolic function (EF 47%).4. Iron overload of the liver and spleen. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.