Imaging from an 18-year-old male patient with homozygous hemoglobin SS disease. (A,B) CT scan demonstrating large pulmonary artery and mosaic perfusion pattern due to areas of higher radiodensity where the blood flow is high (more white), next to darker areas where the pulmonary arterioles are narrowed and blood flow is reduced. (C) Doppler echocardiographic study records a very high tricuspid regurgitant jet velocity (TRV) of 5.93 m/s, which estimates a pulmonary artery systolic pressure of greater than 140 mm Hg. (D) Four-chamber view of his heart shows shows a dilated right ventricle (RV) and right atrium (RA) with a compressed left ventricle (LV).