Does the presence of an implanted cardiac device adversely affect the image quality of clinically indicated magnetic resonance imaging at 1.5t?

Abstract

Results Between November 2003 and February 2014, 1000 consecutive clinically indicated MRI examinations were performed on 569 patients with an implanted cardiac device at a single center. Scan locations included: Brain 315, spine 358, extremities 82, abdomen/pelvis 56, cardiac 24, shoulder 32 (19 left and 13 right), and orbit/face/head/ neck 133. Cardiac device-related imaging artifacts were reported in 1.0% of non-cardiac scans (11 of 976) which included 7 left shoulders scans with an ipsilateral device (4 ICDs/3 pacemakers), 1 right upper extremity scan with a left-sided pacemaker with metallic artifact (and a prosthetic right humeral head), 1 cervical spine scan with a left-sided pacemaker, 1 neck scan with a right-sided ICD, and 1 orbit/face/neck scan with a left-sided ICD. No significant imaging artifacts were noted in 10 of the 16 left shoulder MRI studies (63%) which included 1 contralateral and 9 ipsilateral cardiac device implant positions. Overall, artifacts were most pronounced on gradient echo images. For cardiac scans, 14 of 24 studies (58%) had a devicerelated artifact which precluded full or partial study interpretation (7 pacemakers/7 ICDs), and all had a left-sided device implant. Cardiac 3-D volumetric assessment could not be performed in 8 studies, delayed-enhancement imaging was not possible in 1 study, and image quality was severely limited in 3 additional studies. Two cardiac studies contained an artifact that adversely affected image quality with the requirement for an alternate imaging modality: one standard cardiac study and one cardiac study with aortic angiography.