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Fig. 1F. —32-year-old man with patent foramen ovale grade 3 on transesophageal echocardiography and grade 3 on MRI. Figures 1A and 1H show anatomy using true fast imaging with steady-state free precession–cine sequence in horizontal long axis (A) and short axis (H) at atrial level. Figures 1B–1G and 1I–1N show temporal sequence of contrast-enhanced dynamic perfusion imaging during Valsalva maneuver. Figures 1B and 1I show baseline signal without enhancement. Figures 1C and 1J show enhancement of right atrium (RA). Figures 1D and 1K show enhancement of entire left atrium (LA) due to right-to-left shunting (arrows) before enhancement of pulmonary vein (PV). Figures 1E and 1L show signal decrease in LA representing dip after first initial peak back to baseline. Figures 1F and 1M show enhancement of PV and second signal peak in LA. Figures 1G and 1N show enhancement of aorta. RV = right ventricle, LV = left ventricle, RV = right ventricle, Ao = aorta, PA = pulmonary artery.