MRA Abdomen Vascular imaging of the abdomen may be helpful in the cases of infracardiac TAPVC or PAPVC to demonstrate the drainage of pulmonary vein into hepatic vein or portal vein. It may be needed to assess the resulting complications such as portal venous system aneurysm formation and collaterals. MRA Chest MRA chest is excellent at identifying the anatomy, specifically the anomalous course and connections of the pulmonary veins [68,69]. A small case study showed that MRA chest was more accurate than both echocardiography and cardiac catheterization in accurately identifying the anomalous veins in 7 patients with TAPVC [70]. MRI Heart Function and Morphology MRI heart function and morphology is complementary to MRA chest and can be performed during the same imaging session. MRI heart function and morphology is useful in cases of PAPVC, because it is the ideal noninvasive modality to quantify the shunt amount by means flow rate assessment, ventricular muscle masses, and ventricular volumes and function [68,71]. The shunt quantification is usually performed using phase-contrast imaging through the aorta and pulmonary vein. MRI Heart Function with Stress There is no relevant literature to support the use of MRI heart function with stress in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. Radiography Chest Chest radiography may demonstrate additional findings such as associated dextrocardia, signs of vascular congestion, and pulmonary edema, which may point towards obstructed TAPVC [65]. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT heart in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE.
Congenital or Acquired Heart Disease. MRA Abdomen Vascular imaging of the abdomen may be helpful in the cases of infracardiac TAPVC or PAPVC to demonstrate the drainage of pulmonary vein into hepatic vein or portal vein. It may be needed to assess the resulting complications such as portal venous system aneurysm formation and collaterals. MRA Chest MRA chest is excellent at identifying the anatomy, specifically the anomalous course and connections of the pulmonary veins [68,69]. A small case study showed that MRA chest was more accurate than both echocardiography and cardiac catheterization in accurately identifying the anomalous veins in 7 patients with TAPVC [70]. MRI Heart Function and Morphology MRI heart function and morphology is complementary to MRA chest and can be performed during the same imaging session. MRI heart function and morphology is useful in cases of PAPVC, because it is the ideal noninvasive modality to quantify the shunt amount by means flow rate assessment, ventricular muscle masses, and ventricular volumes and function [68,71]. The shunt quantification is usually performed using phase-contrast imaging through the aorta and pulmonary vein. MRI Heart Function with Stress There is no relevant literature to support the use of MRI heart function with stress in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. Radiography Chest Chest radiography may demonstrate additional findings such as associated dextrocardia, signs of vascular congestion, and pulmonary edema, which may point towards obstructed TAPVC [65]. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT heart in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE.