24 year old male with dilated cardiomyopathy, referred for cardiac MRI to evaluate for etiology of LV dysfunction and possible LV thrombus. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. There is global hypokinesis. The overall LV ejection fraction is 22%, the LV end diastolic volume index is 170 ml/m2 (normal range: 74+/-15), the LVEDV is 432 ml (normal range 142+/-34), the LV end systolic volume index is 132 ml/m2 (normal range 25+/-9), the LVESV is 340 ml (normal range 47+/-19), the LV mass index is 74 g/m2 (normal range 85+/-15), and the LV mass is 190 g (normal range 164+/-36). There is a mid-wall stripe of late gadolinium enhancement in the basal to mid septum , which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern of delayed enhancement is atypical for prior myocardial infarction, and can be seen with dilated cardiomyopathy or prior myocarditis. There is no evidence of LV thrombus.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is mildly dilated with moderately reduced systolic function. The overall RV ejection fraction is 30%, the RV end diastolic volume index is 114 ml/m2 (normal range 82+/-16), the RVEDV is 294 ml (normal range 142+/-31), the RV end systolic volume index is 81 ml/m2 (normal range 31+/-9), and the RVESV is 207 ml (normal range 54+/-17).Right AtriumThe right atrium is severely dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least moderate 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 normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no pericardial effusion.
1. Left ventricle is severely dilated with severely reduced systolic function (LVEF 22%). There is no evidence of LV thrombus.2. There is a mid-wall stripe of late gadolinium enhancement in the basal to mid septum , which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern of delayed enhancement is atypical for prior myocardial infarction, and can be seen with dilated cardiomyopathy or prior myocarditis. There is no evidence of LV thrombus.3. Right ventricle is mildly dilated with moderately reduced systolic function (RVEF 30%)4. At least moderate mitral regurgitation.5. Mild tricuspid regurgitation.6. Severe bi-atrial enlargement.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.