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. 2020 Dec 11;51(8):1503–1517. doi: 10.1007/s00247-020-04885-w

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 8 — Pulmonary atresia, ventricular septal defect, confluent pulmonary arteries and multiple major aortopulmonary collaterals in an 18-month-old girl after shunt placement between right ventricle and pulmonary artery bifurcation. a Axial magnetic resonance (MR) angiography maximum-intensity projection shows a small-diameter shunt with distal shunt stenosis at the bifurcation (asterisk) as well as a tiny right pulmonary artery (RPA) and a proximally stenotic left pulmonary artery (LPA). b Corresponding axial 4-D flow velocity map reveals high velocities within the shunt (red). Flow assessment is feasible in all three arteries (black ovals). c Coronal 4-D flow colour-coded pathlines demonstrate blood flow separation of the right (RV) and left (LV) ventricles without real mixing despite the ventricular septal defect: RV blood (blue) mainly runs into the brachiocephalic trunk and left carotid artery, whereas LV blood (red) flows into the left subclavian artery