Löbe S, Paetsch I, Hilbert S, Spampinato R, Oebel S, Richter S, Döring M, Sommer P, Bollmann A, Hindricks G, Jahnke C
Department of Electrophysiology, HELIOS Heart Center Leipzig, University of Leipzig, Germany.
Department of Electrophysiology, HELIOS Heart Center Leipzig, University of Leipzig, Germany.
Int J Cardiol. 2020 Oct 1;316:266-271. doi: 10.1016/j.ijcard.2020.05.021. Epub 2020 May 7.
Patients with cardiac implantable electronic devices (CIED) necessitate comprehensive cardiovascular magnetic resonance (CMR) examinations. The aim of this study was to provide data on CMR image quality and feasibility of functional assessment of the right heart in patients with CIED depending on the device type and imaging sequence used.
120 CIED carriers (Insertable cardiac monitoring system, n = 13; implantable loop-recorder, n = 22; pacemaker, n = 30; implantable cardioverter-defibrillator (ICD), n = 43; and cardiac resynchronization therapy defibrillator (CRT-D), n = 12) underwent clinically indicated CMR imaging using a 1.5 T. CMR protocols consisted of cine imaging and myocardial tissue characterization including T1-and T2-weighted blackblood imaging and late gadolinium enhancement (LGE) imaging. Image quality was evaluated with regard to device-related imaging artifacts per right-ventricular (RV) segment.
RV segmental evaluability was influenced by the device type and CMR imaging sequence: Cine steady-state-free-precision (SSFP) imaging was found to be non-diagnostic in patients with ICD/CRT-D and implantable loop recorders; a significant improvement of image quality was achieved when using cine turbo-field-echo (TFE) sequences with a further improvement on post-contrast TFE imaging. LGE scans were artifact-free in at least 91% of RV segments with best results in patients with a pacemaker or an insertable cardiac monitoring system.
In patients with CIED, artifact-free CMR imaging of the right ventricle was performed in the majority of patients and resulted in highly reproducible evaluability of RV functional parameters. This finding is of particular importance for the diagnosis and follow-up of right-ventricular diseases.
心脏植入式电子设备（CIED）患者需要进行全面的心血管磁共振（CMR）检查。本研究的目的是根据设备类型和所使用的成像序列，提供有关CIED患者CMR图像质量和右心功能评估可行性的数据。
120名CIED携带者（可插入式心脏监测系统，n = 13；植入式环形记录仪，n = 22；起搏器，n = 30；植入式心脏复律除颤器（ICD），n = 43；心脏再同步治疗除颤器（CRT-D），n = 12）使用1.5T进行临床指征性CMR成像。CMR方案包括电影成像和心肌组织特征分析，包括T1加权和T2加权黑血成像以及延迟钆增强（LGE）成像。根据右心室（RV）节段的设备相关成像伪影评估图像质量。
RV节段的可评估性受设备类型和CMR成像序列的影响：发现电影稳态自由精度（SSFP）成像在ICD/CRT-D和植入式环形记录仪患者中无法诊断；使用电影涡轮场回波（TFE）序列时图像质量有显著改善，对比后TFE成像进一步改善。LGE扫描在至少91%的RV节段中无伪影，在起搏器或可插入式心脏监测系统患者中结果最佳。
在CIED患者中，大多数患者进行了右心室无伪影CMR成像，结果显示RV功能参数具有高度可重复性的可评估性。这一发现对于右心室疾病的诊断和随访尤为重要。
