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

BackgroundMagnetic resonance imaging (MRI) of pacemaker patients has become available despite of previous contraindications. However, pacing systems containing ferromagnetic material may hamper the diagnostic quality of cardiac MR (CMR) images.PurposeTo study methods for reducing susceptibility-based artifacts in CMR examinations of pacemaker patients.Material and MethodsAltogether 16 patients were scanned with 1.5T MRI scanner using cine balanced steady-state free-precession (bSSFP) and spoiled gradient echo (SPGR) sequences. The use of frequency-scout was also evaluated. For myocardial late gadolinium-enhanced (LGE) imaging, SPGR or bSSFP readout inversion-recovery prepared gradient echo sequences were used with and without phase-sensitive inversion-recovery (PSIR). Two radiologists subjectively compared the image quality (IQ) and the ranges of susceptibility artifacts were evaluated objectively.ResultsThe IQ proved adequate for diagnosing each patient, although in a few patients with a left-side implan...