Fig. 3

A–Q CMR revealed: Dilated RV with fair systolic function, preserved LVEF, moderate PR, RF = 36%, residual PS with maximum velocity = 3.5 m/s, RPA branch stenosis 3 m/s and LPA branch stenosis 2.5 m/s, mild TR, moderate MR, residual VSD with Qp/Qs = 1.5:1. A 23-year-old female patient, diagnosed as tetralogy of Fallot, underwent RVOT repair at age of 1-year-old and mitral valve replacement as well. The patient was referred for RV volumes, function and Qp/Qs quantification. A, B, C 4-chamber cine, left 2-chamber cine and left 3-chamber cine images showing mild tricuspid regurgitation and moderate mitral regurgitation on top of mitral valve replacement. D, E, F Three sequential images from VSD cine showing the systolic jet through the VSD. G, H Coronal pulmonary cine images during systole showing stenotic jet and during diastole showing dephasing regurgitant jet. I Sagittal pulmonary in-plane phase-contrast velocity encoding sequence (phase) showing aliasing across the pulmonary valve at Venc 2.5 m/s needing increasing the Venc for optimal flow assessment. J, K Coronal pulmonary in-plane phase-contrast velocity encoding sequence (magnitude and phase) showing no aliasing across the pulmonary valve at Venc 3.5 m/s denoting optimal Venc for optimal flow assessment. L, M, N, O Sagittal phase-contrast velocity encoding sequences in-plane RPA and LPA (anatomy and phase images) with Venc 2.5 and 2 m/s, respectively, showing aliasing across phase images of both denoting pulmonary branches stenosis and so the need to increase Venc for proper assessment. P, Q Feature-tracking analysis of short-axis mid-ventricular level and 4-chamber cine in the form of LV endocardial and epicardial contouring as well as RV endocardial contouring, LV circumferential strain (− 12.3%), RV circumferential strain (− 8.6%), radial strain LV (20.2%), LV longitudinal strain (− 14.9%) (4chamber), RV longitudinal strain (− 10.3%), (low feature-tracking RV and LV strain values)