KyungPyo Hong1, Jeremy D Collins1, Bradley P Knight2, James C Carr1, Daniel C Lee1,2, Daniel Kim1,3. 1. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL. 2. Division of Cardiology, Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 3. Department of Biomedical Engineering, Northwestern University, Evanston, IL.
Abstract
PURPOSE: To develop a wideband cardiac perfusion pulse sequence and test whether it is capable of suppressing image artifacts in patients with a cardiac implantable electronic device (CIED), while not exceeding the specific absorption rate (SAR) limit (2.0 W/kg). METHODS: A wideband perfusion pulse sequence was developed by incorporating a wideband saturation pulse to achieve a good balance between saturation of magnetization and SAR. Clinical standard and wideband perfusion MRI scans were performed back-to-back in a randomized order on 16 patients with a CIED undergoing clinical cardiac MRI. Two expert readers graded the artifact intensity and extent on a segmental basis using a 5-point Likert scale, where significant artifact was defined by a composite score. The variance in myocardial signal prior to tissue-enhancement was analyzed to quantify artifact-intensity. Whole-body SAR values computed by the MR scanner were read from the DICOM header. Either a paired t-test or Wilcoxon signed-rank test was performed to compare two groups. RESULTS: While the mean whole-body SAR for a single-slice wideband perfusion scan (0.38 ± 0.08W/kg) was significantly (p < 0.05) higher than for a single-slice standard perfusion scan (0.11 ± 0.03W/kg), it was 81% below 2.0 W/kg. The mean variance in myocardial signal prior to tissue-enhancement was significantly (p < 0.001) higher for standard (422.6 ± 306.6 a.u.) than wideband (107.0 ± 60.9 a.u.). Among 105 myocardial segments, standard produced 19 segments (18%) that were deemed to have significant artifacts, whereas wideband produced only 3 segments (3%). CONCLUSION: A wideband perfusion pulse sequence is capable of suppressing image artifacts induced by a CIED while not exceeding SAR at 2.0 W/kg.
PURPOSE: To develop a wideband cardiac perfusion pulse sequence and test whether it is capable of suppressing image artifacts in patients with a cardiac implantable electronic device (CIED), while not exceeding the specific absorption rate (SAR) limit (2.0 W/kg). METHODS: A wideband perfusion pulse sequence was developed by incorporating a wideband saturation pulse to achieve a good balance between saturation of magnetization and SAR. Clinical standard and wideband perfusion MRI scans were performed back-to-back in a randomized order on 16 patients with a CIED undergoing clinical cardiac MRI. Two expert readers graded the artifact intensity and extent on a segmental basis using a 5-point Likert scale, where significant artifact was defined by a composite score. The variance in myocardial signal prior to tissue-enhancement was analyzed to quantify artifact-intensity. Whole-body SAR values computed by the MR scanner were read from the DICOM header. Either a paired t-test or Wilcoxon signed-rank test was performed to compare two groups. RESULTS: While the mean whole-body SAR for a single-slice wideband perfusion scan (0.38 ± 0.08W/kg) was significantly (p < 0.05) higher than for a single-slice standard perfusion scan (0.11 ± 0.03W/kg), it was 81% below 2.0 W/kg. The mean variance in myocardial signal prior to tissue-enhancement was significantly (p < 0.001) higher for standard (422.6 ± 306.6 a.u.) than wideband (107.0 ± 60.9 a.u.). Among 105 myocardial segments, standard produced 19 segments (18%) that were deemed to have significant artifacts, whereas wideband produced only 3 segments (3%). CONCLUSION: A wideband perfusion pulse sequence is capable of suppressing image artifacts induced by a CIED while not exceeding SAR at 2.0 W/kg.
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