Clinical history 51-year-old woman with cardiomyopathy and heart failure. Echocardiography findings suspicious for non-compaction of the left ventricle. MRI requested for further evaluation.
Cardiac MRI was performed on 12/19/2012. Cardiac gated cine-imaging was performed through the heart in long axis and short axis planes using a steady state free procession pulse sequence. Black blood imaging in the 4 chamber and 2 chamber views through
the left ventricle was also performed using a double inversion recovery fast spin-echo sequence. Gadolinium was administered intravenously and myocardial delayed enhancement imaging was performed in the short axis and long axis planes through the left ventricle.
There is cardiomegaly with enlargement of all cardiac chambers. Diffuse hypokinesia is also present. The appearance is consistent with cardiomyopathy. A small amount of mitral and tricuspid valve regurgitation is also noted. Evaluation of the left
ventricular cavity shows increased trabeculation of the left ventricle predominantly along the lateral wall, apex and anterior wall. The trabeculated myocardial layer measures approximately 22 mm in thickness while the compacted myocardium measures
approximately 7 mm in thickness. The appearance is consistent with left ventricular non-compaction. Calculated ejection fraction is 14 percent.
Myocardial delayed enhancement shows abnormal delayed enhancement along the inferior wall and septum in a mid myocardial distribution with sparing of the endocardium. The appearance is consistent with myocarditis.
Although thrombus was reported within the left ventricle on recent echocardiography, no definite thrombus is visualized in the left ventricle on this study. The pericardium is normal in thickness. There is no significant pericardial effusion. No pleural
effusions are seen.
Cardiac MRI was performed on 12/19/2012. Cardiac gated cine-imaging was performed through the heart in long axis and short axis planes using a steady state free procession pulse sequence. Black blood imaging in the 4 chamber and 2 chamber views through
the left ventricle was also performed using a double inversion recovery fast spin-echo sequence. Gadolinium was administered intravenously and myocardial delayed enhancement imaging was performed in the short axis and long axis planes through the left ventricle.
There is cardiomegaly with enlargement of all cardiac chambers. Diffuse hypokinesia is also present. The appearance is consistent with cardiomyopathy. A small amount of mitral and tricuspid valve regurgitation is also noted. Evaluation of the left
ventricular cavity shows increased trabeculation of the left ventricle predominantly along the lateral wall, apex and anterior wall. The trabeculated myocardial layer measures approximately 22 mm in thickness while the compacted myocardium measures
approximately 7 mm in thickness. The appearance is consistent with left ventricular non-compaction. Calculated ejection fraction is 14 percent.
Myocardial delayed enhancement shows abnormal delayed enhancement along the inferior wall and septum in a mid myocardial distribution with sparing of the endocardium. The appearance is consistent with myocarditis.
Although thrombus was reported within the left ventricle on recent echocardiography, no definite thrombus is visualized in the left ventricle on this study. The pericardium is normal in thickness. There is no significant pericardial effusion. No pleural
effusions are seen.