Abstract 10366: Quantitative Assessment of Artifacts on Cardiac Magnetic Resonance Imaging of Patients with Pacemakers and Implantable Defibrillators
Introduction: Clinical feasibility and safety of noncardiac and cardiac magnetic resonance imaging (MRI) at 1.5T in patients with cardiac implantable devices (CID) has been investigated in previous reports. This study aims to evaluate the effects of artifacts on cardiac MRI in patients with CID.
Methods: Of 62 patients who underwent 66 clinical cardiac MRI studies, 8 had a pacemaker (PM) and 56 had an implantable cardioverter defibrillator (ICD) or biventricular (BIV) ICD. In all patients except 3, CID was implanted in the left precordial region. All MRI studies at 1.5T were performed with an established safety protocol. The area of artifact around the CID generator was measured in cine MRI and delayed enhanced (DE) MRI. The location and the extent of the artifacts were determined in every short axis plane of DE-MRI divided into 20 radial segments.
Results: The mean area of the artifacts was 185.9±49.6 cm2 in cine MRI and 181.3±42.4 cm2 in DE MRI. There was a significant difference in artifact area induced by PM vs. ICD/BIV-ICDs (87.3±29.6 cm2 vs. 199.7±30.4 cm2 in cine MRI, 101.0±10.1 cm2 vs. 188.4±34.9 cm2 in DE MRI, respectively; P<0.001). Out of a total of 8392 segments (425 short axis planes) on DE MRI, 4379 segments (52.2%) were required to be excluded due to the artifacts. Anterior and apical myocardial regions on DE-MRI were more severely affected by the artifact. Excluded segments on DE MRI were much greater in ICD and BIV-ICD devices compared to PM (58% in ICD/BIV-ICD vs. 10.1% in PM, P<0.001).
Conclusions: About 50% of the myocardial area on DE MRI, especially the anterior region, was severely affected by the artifacts from CID generator. Artifact reduction methodologies will be necessary to improve the performance of cardiac MRI in patients with CID.
- © 2010 by American Heart Association, Inc.