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Fig. 1D —42-year-old man with right-to-left shunt before and absence
of residual shunt after occlusion of patent foramen ovale (PFO). Temporal
sequence of contrast-enhanced dynamic perfusion images during Valsalva
maneuver before transcatheter occlusion of PFO. Images show baseline signal
intensity without enhancement, (RA = right atrium, RV = right ventricle, LA =
left atrium, LV = left ventricle, PV = pulmonary vein, PA = pulmonary artery)
(A), enhancement of right atrium, slight enhancement of pulmonary
artery, and enhancement of entire left atrium due to right-to-left-shunt
(arrow) before enhancement of pulmonary vein (B), decrease in
signal intensity in left atrium representing dip back to baseline after first
initial peak (C), and enhancement of pulmonary vein and second signal
peak in left atrium (D).
