Fig. 6

A Selective injection angiogram in a patient with a right sided Glenn with a normal pulmonary transit time. From left to right, the panels show the flow of the injected contrast agent from the superior vena cava (blue arrows), directly to the lungs, and back into the heart over several heartbeats with x-ray fluoroscopy and CMR in coronal planes. A manually-selected threshold was applied to the T1-weighted CMR to overlay the bright gadoliniumsignal on the high-resolution 3D dataset acquired at the beginning of the session, providing real-time visualization of the contrast flow patterns. In this patient (A), atrial filling (orange arrow) was not observed until the 5th heartbeat (third column) with both modalities, indicating normal transit time through the lungs. B Selective injection angiogram in another patient with a right sided Glenn (blue arrow) with T1-overlay images acquired in coronal and axial planes simultaneously. The second time point (middle column) shows rapid atrial filling (less than 2 heartbeats after the injection) with both modalities, suggesting the presence of pulmonary arteriovenous malformations (AVMs) in the right lung, which were confirmed by fluoroscopy in this patient. Videos of these selective angiograms can also be seen in Additional file 3