起搏器和植入式心脏复律除颤器患者心脏磁共振成像伪影的定量评估。
Quantitative assessment of artifacts on cardiac magnetic resonance imaging of patients with pacemakers and implantable cardioverter-defibrillators.
机构信息
Department of Medicine/Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Circ Cardiovasc Imaging. 2011 Nov;4(6):662-70. doi: 10.1161/CIRCIMAGING.111.965764. Epub 2011 Sep 23.
BACKGROUND
The safety and clinical utility of MRI at 1.5 T in patients with cardiac implantable devices such as pacemakers (PM) and implantable cardioverter-defibrillators (ICD) have been reported. This study aims to evaluate the extent of artifacts on cardiac magnetic resonance (CMR) in patients with PM and ICD (PM/ICD).
METHODS AND RESULTS
A total of 71 CMR studies were performed with an established safety protocol in patients with prepectoral PM/ICD. The artifact area around the PM/ICD generator was measured in all short-axis (SA), horizontal (HLA), and vertical long-axis (VLA) SSFP cine planes. The location and extent of artifacts were also assessed in all SA (20 sectors per plane), HLA, and VLA (6 sectors per plane) late gadolinium-enhanced CMR (LGE-CMR) planes. The artifact area on cine CMR was significantly larger with ICD versus PM generators in each plane (P<0.001, respectively). In patients with left-sided ICD or biventricular ICD systems, the percentages of sectors with any artifacts on LGE-CMR were 53.7%, 48.0%, and 49.2% in SA, HLA, and VLA planes, respectively. Patients with left-sided PM or right-sided PM/ICD had fewer artifacts. Anterior and apical regions were severely affected by artifact caused by left-sided PM/ICD generators.
CONCLUSIONS
In contrast to patients with right-sided PM/ICD and left-sided PM, the anterior and apical left ventricle can be affected by susceptibility artifacts in patients with left-sided ICD. Artifact reduction methodologies will be necessary to improve the performance of CMR in patients with left sided ICD systems.
背景
已经有报道称，1.5T 磁共振成像（MRI）在心脏植入式设备（如起搏器[PM]和植入式心脏复律除颤器[ICD]）患者中的安全性和临床实用性。本研究旨在评估 PM 和 ICD（PM/ICD）患者心脏磁共振（CMR）中的伪影程度。
方法和结果
在具有预先胸肌 PM/ICD 的患者中，使用既定的安全方案进行了总共 71 项 CMR 研究。在所有短轴（SA）、水平（HLA）和垂直长轴（VLA）SSFP 电影平面上测量 PM/ICD 发生器周围的伪影区域。还评估了所有 SA（每个平面 20 个扇区）、HLA 和 VLA（每个平面 6 个扇区）延迟钆增强 CMR（LGE-CMR）平面上的伪影位置和程度。在每个平面中，与 PM 发生器相比，ICD 发生器的电影 CMR 伪影区域明显更大（P<0.001）。在左侧 ICD 或双心室 ICD 系统的患者中，SA、HLA 和 VLA 平面上任何 LGE-CMR 有伪影的扇区百分比分别为 53.7%、48.0%和 49.2%。左侧 PM 或右侧 PM/ICD 的患者伪影较少。左侧 PM/ICD 发生器引起的伪影严重影响了前壁和心尖区域。
结论
与右侧 PM/ICD 和左侧 PM 的患者相比，左侧 ICD 的患者的前壁和心尖部左心室可能会受到来自敏感性伪影的影响。为了提高左侧 ICD 系统患者的 CMR 性能，需要采用减少伪影的方法。
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