Imaging techniques | Pros | Cons |
Perfusion scintigraphy | Perfusion deficits likely in pressure gradients left atrium/pulmonary vein >5 mmHg and/or >80% stenosis | Low specificity, perfusion deficits in cases with pulmonary embolism |
Transoesophageal echocardiography | Information about left and right heart function | Inferior pulmonary vein difficult to visualise |
Consider relevant stenosis if: | Anomalies like accessory pulmonary veins, common left trunk or hypoplasia are often missed | |
pulmonary vein flow velocity >100 cm·s−1 | ||
pulmonary vein diameter <5 mm | ||
Underestimates pulmonary vein diameter | ||
3D-MRA venography | Simultaneous visualisation of: | Limited post-processing |
mediastinal structures | ||
left and right heart function | ||
partial anomalous venous return | ||
Flow quantification with phase contrast | Limited visualisation of the pulmonary parenchyma | |
3D-CT venography | Data acquisition within a few seconds | Iodine contrast media and radiation exposure |
Simultaneous visualisation of: | ||
pulmonary parenchyma | ||
mediastinal structures | ||
left and right heart | ||
Post-processing possible in all planes | ||
Direct venography | Can be used in combination with therapeutic interventions | Most invasive |
Retrograde pulmonary vein detection in near-total occlusion | Lowest sensitivity for the detection of pulmonary veins in comparison with the other techniques | |
Assessment pressure gradient from pulmonary vein pressure to left atrium pressure | Overestimates diameter of pulmonary veins | |
Restricted to luminography |
3D: three-dimensional; MRA: magnetic resonance angiography; CT: computed tomography.