PMID- 31120781
OWN - NLM
STAT- MEDLINE
DCOM- 20200122
LR  - 20200122
IS  - 1546-3141 (Electronic)
IS  - 0361-803X (Linking)
VI  - 213
IP  - 3
DP  - 2019 Sep
TI  - Metal Artifact Reduction in Cardiovascular MRI for Accurate Myocardial Scar 
      Assessment in Patients With Cardiac Implantable Electronic Devices.
PG  - 555-561
LID - 10.2214/AJR.19.21187 [doi]
AB  - OBJECTIVE. An important application of late gadolinium enhancement (LGE) cardiac 
      MRI is accurate assessment of myocardial scar before ablation. However, this is 
      often limited in patients with cardiac implantable electronic devices (CIEDs) 
      because of metal device-induced artifacts. The purpose of this study was to 
      determine whether a modified wideband inversion recovery (IR) LGE MRI technique 
      decreases artifact volume to allow the assessment of myocardial scar. SUBJECTS 
      AND METHODS. Fifty patients (17 women and 33 men; mean age +/- SD, 61 +/- 12 years; 
      mean ejection fraction +/- SD, 35.9% +/- 13.3%) with CIEDs underwent cardiac MRI 
      using conventional and modified wideband IR LGE techniques before ablation. The 
      volume of device-induced artifact was quantified and stratified by tertiles on 
      mild, moderate, and severe. Ordinal logistic regression analysis assessed the 
      association between artifact volume on conventional and wideband images adjusted 
      for patients' demographics. RESULTS. Conventional LGE MRI resulted in 
      device-induced hyperintense artifacts that obscured ventricular segments in 32 of 
      50 (64%) cases. Wideband LGE MRI significantly reduced severe artifact volume (p 
      < 0.0001) and completely resolved all mild and most moderate artifacts. Overall, 
      wideband techniques resulted in a 56% reduction in total artifact volume for the 
      cohort (p < 0.0001). The wideband LGE MRI sequence minimized artifacts in the 
      most commonly obscured segments on the conventional LGE MRI sequence, with 
      persistent artifacts in seven, eight, and four of 32 cases at the basal anterior, 
      midventricular anterior, and midventricular anteroseptal segments, respectively. 
      CONCLUSION. The modified wideband IR technique completely resolves mild and 
      moderate device-induced hyperintense artifacts and significantly reduces the 
      volume of severe artifact to allow accurate identification of myocardial scar in 
      patients with CIEDs before ablation.
FAU - Runge, Mason
AU  - Runge M
AD  - University of Michigan Medical School, Ann Arbor, MI.
FAU - Ibrahim, El-Sayed H
AU  - Ibrahim EH
AD  - Department of Radiology, Medical College of Wisconsin, Milwaukee, WI.
FAU - Bogun, Frank
AU  - Bogun F
AD  - Cardiovascular Center, University of Michigan, Ann Arbor, MI.
FAU - Attili, Anil
AU  - Attili A
AD  - Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Rm 
      5481, Ann Arbor, MI 48109-5868.
FAU - Mahani, Maryam Ghadimi
AU  - Mahani MG
AD  - Department of Radiology, C. S. Mott Children's Hospital, Ann Arbor, MI.
FAU - Pang, Yuxi
AU  - Pang Y
AD  - Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Rm 
      5481, Ann Arbor, MI 48109-5868.
FAU - Horwood, Laura
AU  - Horwood L
AD  - Cardiovascular Center, University of Michigan, Ann Arbor, MI.
FAU - Chenevert, Thomas L
AU  - Chenevert TL
AD  - Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Rm 
      5481, Ann Arbor, MI 48109-5868.
FAU - Stojanovska, Jadranka
AU  - Stojanovska J
AD  - Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Rm 
      5481, Ann Arbor, MI 48109-5868.
LA  - eng
PT  - Journal Article
DEP - 20190523
PL  - United States
TA  - AJR Am J Roentgenol
JT  - AJR. American journal of roentgenology
JID - 7708173
RN  - 0 (Contrast Media)
RN  - 0 (Metals)
SB  - IM
MH  - *Artifacts
MH  - Cicatrix/*diagnostic imaging
MH  - Contrast Media
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Metals
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - *Pacemaker, Artificial
MH  - Prospective Studies
OTO - NOTNLM
OT  - cardiac-implantable electronic device (CIED)
OT  - late gadolinium enhancement
OT  - metal artifact
OT  - myocardial scar
OT  - ventricular tachycardia
EDAT- 2019/05/24 06:00
MHDA- 2020/01/23 06:00
CRDT- 2019/05/24 06:00
PHST- 2019/05/24 06:00 [pubmed]
PHST- 2020/01/23 06:00 [medline]
PHST- 2019/05/24 06:00 [entrez]
AID - 10.2214/AJR.19.21187 [doi]
PST - ppublish
SO  - AJR Am J Roentgenol. 2019 Sep;213(3):555-561. doi: 10.2214/AJR.19.21187. Epub 
      2019 May 23.