Abstract 15765: Does the Presence of an Implanted Cardiac Device Adversely Affect the Quality of Images in Clinically-Indicated Magnetic Resonance Imaging at 1.5T
Introduction: The risk of adverse clinical events for patients with standard pacemakers and implanted cardioverter-defibrillators (ICD) who undergo clinically-indicated MRI at 1.5T is currently being investigated. The purpose of the present study is to evaluate the image quality of clinically-indicated MRI at 1.5T for patients with pacemakers and ICDs.
Methods: A retrospective single-center analysis was performed to evaluate MRI examinations performed between February 2006 and June 2012 for patients with implanted cardiac devices. Reports of the interpreting radiologist were reviewed for (1) a successful examination, (2) recognition that a cardiac device-related-artifact was present, (3) notation that artifact was present which affected the interpretation of the study; or (4) an impression that the study was non-diagnostic due to an artifact and an alternate form of imaging recommended.
Results: A total of 536 non-cardiac MRI examinations were performed in patients with pacemakers or ICDs. Anatomic scan region was the Brain in 189 studies; Cervical Spine 68; Shoulder 14; Thoracic Spine 20; Orbit/IAC/Neck 19; Soft Tissue Neck 4 and 222 other (distant from the device implant). A device-related artifact was noted in 6 scans (1.1%) which included 4 left shoulders, 1 C-spine and 1 elbow. The four left shoulder exams were performed in patients with a left device implant. Artifact was most pronounced on gradient echo images and in the coronal plane. There were two additional left and one right shoulder scan with ipsilateral devices, none with reported artifact. A left subclavian MR angiogram in a patient with an ipsilateral ICD had no artifact. The cervical-spine exam noted a small artifact which was likely due to prior surgical fusion. Artifacts noted in the elbow exam were also unrelated to the cardiac device. In the 4 scans with true cardiac device-related artifact, the examinations were interpreted as diagnostic, and alternative imaging was not necessary or recommended.
Conclusion: The presence of an implanted pacemaker or ICD does not affect the image quality of clinically-indicated MRI at 1.5T. Imaging artifacts are noted in a small number of patients without adversely affecting image quality or diagnostic utility of the images obtained.
- © 2012 by American Heart Association, Inc.