Figure 14b. PAPVR in a 64-year-old woman. (a, b) Axial (a) and coronal (b) ECG-gated spin-echo images show drainage of the right upper lobe pulmonary vein (arrow) into the superior vena cava (SVC). Note the enlarged pulmonary artery (PA) in a, consistent with pulmonary arterial hypertension. (c) Axial spin-echo image at a lower level shows an associated atrial septal defect (arrow) in the sinus venosus. (d) Coronal gadolinium-enhanced MR angiographic image again shows drainage of the right upper lobe pulmonary vein (arrow) into the superior vena cava. The right upper lobe pulmonary vein is the most common anomalous vein. Ao = aorta, LA = left atrium.