The construction of a mesoatrial shunt for portal decompression is one of the surgical procedures used for the treatment of Budd-Chiari syndrome. The results of the imaging procedures performed in eight patients treated in this fashion were retrospectively analyzed. All of the patients had angiography; seven had MR imaging and two had Doppler sonography. The demonstration of shunt patency, stenosis, or occlusion by MR and Doppler sonography was confirmed by angiography in all cases. We conclude that MR imaging may serve as an accurate screening method to assess shunt patency and to determine which patients require angiography to obtain hemodynamic data. Doppler sonography may also be a useful screening method, but additional data must be obtained to assess its role in evaluation of shunt patency.