Cardiovascular magnetic resonance in patients with magnetic resonance conditional pacemaker systems at 1.5 T: influence of pacemaker related artifacts on image quality including first pass perfusion, aortic and mitral valve assessment, flow measurement, short tau inversion recovery and T1-weighted imaging.
There are only limited data on the impact of device-related artifacts on image quality in cardiovascular magnetic resonance imaging (CMR) in patients with pacemakers (PM). Adenosine stress perfusion, T1-weighted imaging and flow measurement as well as valve characterization have not been evaluated previously concerning artifact burden. We aimed to assess image quality in all routinely used CMR sequences. We analyzed 2623 myocardial segments in CMR scans of 61 patients with MR conditional PM (mean age 72.1 ± 11.5 years), 23 (37.7%) with right sided, 38 (62.3%) with left-sided devices. There were no relevant artifacts in patients with right-sided devices irrespective of the imaging sequence. In left-sided implants no PM-induced artifacts were found in first pass perfusion sequence, flow analysis and T1 weighted imaging. Only few patients with left-sided devices showed significant PM-artifacts in aortic (3/38, 7.9%)/mitral (n = 2/38, 5.3%) valve imaging and STIR (n = 3/35, 8.6%). In STIR only 14/805 (1.7%) segments were involved. In left-sided PM SSFP cine sequences had more artifact burden than LGE with 377/1505 (25.0%) vs. 162/1505 (10.8%) myocardial segments involved by relevant artifacts respectively (p < 0.001). Apart from cine and LGE imaging in anterior myocardial segments with left-sided implants presence of MRI conditional pacemakers does not affect CMR image quality in multimodal CMR examinations to a significant extent. Our data supports evidence that reduced image quality does not need to be a major concern in PM patients undergoing CMR.
Department of Cardiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany. o.klein-wiele@kk-essen.de.|Department of Cardiology, Katholisches Klinikum Essen, University of Witten/Herdecke, Hülsmannstraße 17, 45355, Essen, Germany. o.klein-wiele@kk-essen.de.
Oliver
O
Klein-Wiele
Department of Radiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany.
Marietta
M
Garmer
Department of Radiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany.
Martin
M
Busch
Department of Radiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany.
Serban
S
Mateiescu
Department of Cardiology, Katholisches Klinikum Essen, University of Witten/Herdecke, Hülsmannstraße 17, 45355, Essen, Germany.
Rhyan
R
Urbien
Department of Cardiology, Katholisches Klinikum Essen, University of Witten/Herdecke, Hülsmannstraße 17, 45355, Essen, Germany.
Gianluca
G
Barbone
Cardiovascular Centre, Josef Hospital, University of Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
Kaffer
K
Kara
Department of Cardiology, Prosper-Hospital Recklinghausen, University of Witten/Herdecke, Mühlenstraße 27, 45659, Recklinghausen, Germany.
Michael
M
Schulte-Hermes
Department of Radiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany.
Frauke
F
Metz
Department of Cardiology, Katholisches Klinikum Essen, University of Witten/Herdecke, Hülsmannstraße 17, 45355, Essen, Germany.
Birgit
B
Hailer
Department of Radiology, Grönemeyer Institut Bochum, University of Witten/Herdecke, Universitätsstraße 142, 44799, Bochum, Germany.
Dietrich
D
Grönemeyer
D000241:Adenosine / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016477:Artifacts; D003287:Contrast Media / Q000008:administration & dosage; D003326:Coronary Circulation; D004867:Equipment Design; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010138:Pacemaker, Artificial / Q000009:adverse effects; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage
D003287:Contrast Media; D014665:Vasodilator Agents; D000241:Adenosine
CMR; Cardiac magnetic resonance; Image quality; MRI conditional; Pacemaker