Figure 2

Panel A illustrates the difficulty in imaging the branch pulmonary arteries by transthoracic echocardiography. Turbulence from the normally increased flow across the right ventricle-pulmonary artery conduit obscures the branch pulmonary artery anatomy. Panel B is in the same patient and branch pulmonary artery stenoses are demonstrated clearly by CMR, which is confirmed at time of cardiac catheterization and angiography in panel C.