Fig. 6
An 18-year-old man with severe idiopathic pulmonary hypertension presented with haemoptysis. Short-axis steady-state free precession cine MR image at early diastole (a) and end diastole (b) shows a huge pulmonary trunk (42 mm), dilated and hypertrophied right ventricle and septal leftwards bowing during early diastole (arrow) that regained a flattened appearance (arrowhead) at the end of diastolic filling. Systolic gradient in the pulmonary trunk obtained from velocity-encoded cine MR images was 65 mmHg and volumetric MR quantification revealed systolic dysfunction of the right ventricle (ejection fraction, 20%) and left ventricle (ejection fraction, 40%; not shown)