Fig. 4

A–L CMR revealed: Dilated RV, aortic regurgitation, RF = 5% with dilated aortic root and Asc.Ao, moderate PR, RF = 40%, residual PS, maximum velocity 2.5 m/s, residual VSD (flow across = 59 ml, maximum velocity reached 4.5 m/s) (estimated gradient about 81 mmHg) and Qp/Qs 1.4:1. A 30-year-old male patient, diagnosed as tetralogy of Fallot, underwent RVOT repair at age of 4-year-old. The patient was referred for CMR study for follow-up (RV volumes, function and Qp/Qs quantification). A, B Right inflow/outflow cine images with and without saturation band showing systolic VSD jet and dilated aortic root. C, D, E Phase-contrast velocity encoding sequence for VSD with Venc 2.5 m/s; anatomy, magnitude and phase images showing aliasing across the VSD at this Venc denoting the need for increasing Venc for proper velocity and flow assessment. F Phase-contrast velocity encoding sequence for VSD with Venc 4.5 m/s; phase image showing no aliasing across the VSD denoting optimum velocity. G, H Sagittal pulmonary phase-contrast velocity encoding sequence (in-plane) at Venc 2 m/s; anatomy and phase showing aliasing denoting need for increasing the Venc for proper velocity and flow assessment. I, J Sagittal pulmonary phase-contrast velocity encoding sequence (in-plane) at Venc 2 m/s; two images, anatomy and phase showing pulmonary regurgitation during diastole. K LVOT cine image showing aortic regurgitant jet during diastole as well as dilated aortic root. L Axial localizer image showing dilated ascending aorta measured at the level of pulmonary bifurcation measuring about 5.19 × 4.9 cm