The management of this complex condition has been largely determined by the morphology of pulmonary arteries and the extracardiac sources of pulmonary blood supply. Although echocardiography and catheter angiography are the traditional imaging techniques used to diagnose PA-VSD, 64-MDCT has become a valuable noninvasive imaging technique in comprehensive evaluation of this condition.

Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.