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Cardiac MRI in patients with cardiac pacemakers: practical methods for reducing susceptibility artifacts and

Touko Kaasalainen1, Sari Kivistö2, Miia Holmström2

  • 1HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Department of Physics, University of Helsinki, Helsinki, Finland touko.kaasalainen@hus.fi.

Acta Radiologica (Stockholm, Sweden : 1987)
|March 14, 2015
PubMed
Abstract

Insights

Pacemaker patients can undergo cardiac MRI, but pacemaker artifacts can affect image quality. Using frequency-scout or specific gradient echo sequences can improve diagnostic quality in these cardiac MRI scans.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Cardiac MRI (CMR) is now feasible for pacemaker patients, overcoming previous contraindications.
  • Ferromagnetic materials in pacing systems can degrade CMR image quality due to susceptibility artifacts.

Purpose of the Study:

  • To investigate methods for minimizing susceptibility artifacts in CMR examinations of pacemaker patients.
  • To assess techniques that improve diagnostic image quality in pacemaker patients undergoing CMR.

Main Methods:

  • 16 patients with pacemakers underwent 1.5T MRI using cine balanced steady-state free-precession (bSSFP) and spoiled gradient echo (SPGR) sequences.
  • Evaluated the utility of frequency-scout and different inversion-recovery techniques (PSIR) for late gadolinium-enhanced (LGE) imaging.
  • Radiologists subjectively assessed image quality (IQ) and objectively measured artifact ranges.

Main Results:

  • Overall diagnostic IQ was adequate, though artifacts affected anterior myocardial segments in some patients with left-sided generators.
  • Frequency-scout effectively relocated banding artifacts away from the left ventricle in bSSFP cine sequences.
  • Artifacts were more severe with IR-bSSFP and PSIR compared to IR-SPGR; artifact ranges were larger in bSSFP (10-12 cm) than SPGR (6 cm) sequences.

Conclusions:

  • Pacemaker-induced artifacts generally do not compromise diagnostic image quality in CMR.
  • Employing frequency-scout before bSSFP cine or utilizing SPGR-based sequences can enhance image quality for pacemaker patients.
Keywords:
CMRfrequency-scoutimage qualitypacemakersusceptibility artifact

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