Abstract

To examine schemes to grade the severity of metal susceptibility artifacts on image quality using cardiac MRI pulse sequences. A post-thoracotomy patient was simulated with a stainless steel sternal wire (Syneture,MA; size=6, diameter=48mm), placed securely on an ACR MRI phantom. Phantom was scanned on a 1.5-T Siemens using cardiac MRI sequences:1)TrueFISP, 2)Gradient-Recalled-Echo (GRE), 3)Turbo-Spin- Echo (TSE), 4)Turbo-Inversion-Recovery-Magnitude (TIRM), 5)Dark- blood-IR-FS (DBFS) with and without the wire (FOV=30×30cm, slice- thickness/slice-gap=7.0/1.5mm, matrix size=192×192, slices=17). Image quality degradation was assessed in terms of signal loss and spatial deformation; signal loss by a) measuring the largest diameter of signal drop and b) number of slices with a signal drop and spatial deformation in VelocityAI (Atlanta,GA) by computing the rigid transformation indices between the phantom's internal grid with and without the metal. Image quality was evaluated in terms of signal loss, spatial deformation and ring artifacts. Signal loss: TruFISP and GRE showed the largest signal drop diameter (13 and 16cm respectively). GRE sequence showed a signal drop in -12 slices where as signal drop occurred in only ∼4-5 slices with other sequences. Spatial deformation: GRE sequence showed the maximum with a ∼9mm grid deflection followed by TSE and DBFS (∼8mm). An average deflection of 5.4mm was observed on most of the sequences except T rueFISP and TIRM (Omm). Rigid body transformation showed a maximum x,y,z-translation of -4.7, 0.3 and 1.69 mm and x,y,z-angular rotation of 0.2, - 1.5 and 0.5° for GRE sequence followed by TSE and DBFS confirming the spatial distortion results. Concentric ring artifacts with signal loss were also observed on TrueFISP and DBFS images. Quantification of cardiac MR sequences to metal tolerance and the impact on image quality has shown that GRE and TrueFISP are the most metal-susceptible and TIRM is the most metal-tolerant sequence in terms of both signal loss and spatial deformation. This study helped in creating a separate cardiac metal protocol comprising of mainly metal-tolerant sequences thus reducing scan time and patient discomfort.

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