Cardiac MRI: Function and Viability

 

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Report
Procedure
Field strength [{decimal} T]
Echo imaging [ ______ ]
Turbospin [ ______ ]
Gradient [ ______ ]
Anatomic definition [ ______ ]
Axis cine
Short [ ______ ]
Long [ ______ ]
Gadolinium contrast
Magnevist [ ______ ]
Multihance [ ______ ]
Optimark [ ______ ]
[ ______ ]
Clinical information
[ ______ ]
Comparison
None [ ______ ]
[ ______ ]
Findings
Left ventricular measurements
LVEDD //Normal range=36-56 mm [{decimal} mm]
LV EF //Normal male = 56-78%; female = 56-78% [{decimal} %]
LV SV [{decimal} ml]
LV EDV //Normal male = 77-195 ml; female = 52-141 ml [{decimal} ml]
LVEDVI [{decimal} mL/meter2]
LVESV //Normal male = 19-72 ml; female = 13-51 ml [{decimal} ml]
LVESVI [{decimal} mL/meter2]
LV cardiac output //Normal male = 2.82-8.82 l/min; female = 2.7-6.0 l/min [{decimal} L/min ]
LV cardiac index [{decimal} L/min/meter2]
BSA //Index values are normalized to a BSA of [{positiveInteger} ]
Valve disease
Aortic valve [ ______ ]
Forward volume
"ml"
decimal
Regurgitant volume
"ml"
decimal
Aortic valve area //smaller than 1.0 cm2 severe; 1.0-1.5 cm2 moderate; 1.5-2.0 cm2 mild; bigger than 2.0 cm2 normal [{decimal} cm2]
Normal [ ______ ]
Regurgitant [ ______ ]
Stenotic [ ______ ]
[ ______ ]
Mitral valve
Normal [ ______ ]
Regurgitant [ ______ ]
Mildly stenotic [ ______ ]
Moderately stenotic [ ______ ]
Severely stenotic [ ______ ]
[ ______ ]
Regurgitant volume
"ml"
decimal
Regurgitant fraction [{decimal} %mL]
Ascending aorta diameter
//in systole
"mm"
decimal
Left atrial dimension //AP x 4-chamber [{decimal} mm]
Left atrial area [{decimal} sq cm]
LV regional wall motion
Normokinetic
"0"
Hypokinetic
"1"
Akinetic
"2"
Dyskinetic
"3"
LV myocardial enhancement
Enhancement //0 = none, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100%
"0"
"1"
"2"
"3"
"4"
Base
Anterior
"0"
"1"
"2"
"3"
"4"
Anterolateral
"0"
"1"
"2"
"3"
"4"
Inferolateral
"0"
"1"
"2"
"3"
"4"
Inferior
"0"
"1"
"2"
"3"
"4"
Inferioseptal
"0"
"1"
"2"
"3"
"4"
Anteroseptal
"0"
"1"
"2"
"3"
"4"
Mid
Anterior
"0"
"1"
"2"
"3"
"4"
Anterolateral
"0"
"1"
"2"
"3"
"4"
Inferolateral
"0"
"1"
"2"
"3"
"4"
Inferior
"0"
"1"
"2"
"3"
"4"
Inferioseptal
"0"
"1"
"2"
"3"
"4"
Anteroseptal
"0"
"1"
"2"
"3"
"4"
Apex
Anterior
"0"
"1"
"2"
"3"
"4"
Lateral
"0"
"1"
"2"
"3"
"4"
Inferior
"0"
"1"
"2"
"3"
"4"
Septum
"0"
"1"
"2"
"3"
"4"
True apex
"0"
"1"
"2"
"3"
"4"
Non-cardiac findings [ ______ ]
Impression
Global systolic LV function
Normal
Mildly impaired [ ______ ]
Moderately impaired [ ______ ]
Severely impaired [ ______ ]
Global systolic RV function
Normal
Mildly impaired [ ______ ]
Moderately impaired [ ______ ]
Severely impaired [ ______ ]
LV viability [ ______ ]
Valvular disease [ ______ ]
Present
Absent [ ______ ]
[ ______ ]