Table 1 Radiological assessment of the pulmonary veins

Echocardiography

• Non-invasive

• No ionising radiation

• Accessible

• Portable

• Real-time imaging

• Haemodynamic data

• Limited evaluation of pulmonary veins and systemic connections.

• Imperfect spatial resolution

• Operator dependent

Pulmonary angiography

• Haemodynamic data

• Pulmonary pressures

• Chamber oxygen saturations

• Invasive

• Limited information on associated congenital cardiothoracic anomalies.

• Relationship to surrounding structures poorly defined.

• Radiation dose considerations

• Contrast allergy

ECG-gated MDCT

• Non-invasive

• Comprehensive thoracic anatomical assessment

• High spatial resolution

• Rapid image acquisition

• Can be used in patients with metallic implants

• Simultaneous coronary artery and cardiac morphological evaluation

• Widely available

• No patient sedation.

• Ionizing radiation exposure

• Potential adverse iodinated contrast reaction

• Inferior temporal resolution to Echo and MRI

• Patient heart-rate control required

Cardiac MRI

• High temporal resolution

• No ionizing radiation

• Accurate ventricular functional analysis

• Accurate anatomical assessment

• Haemodynamic data

• 3D multiplanar reconstruction

• Quantification of shunt ratios.

• Non-contrast angiography is possible

• Available in specialised centres

• Longer duration of image acquisition and analysis

• Images suboptimal with cardiac dysrhythmia or inability of patient to breath hold

• Inferior spatial resolution to CT

• Patient claustrophobia

• Gadolinium contrast reactions.

• More prone to artefact.