Optimized protocols for cardiac magnetic resonance imaging in patients with thoracic metallic implants

Abstract

Imaging sequences tailored to minimize metal artifact are easily created by modifying basic sequence parameters, and images are superior to standard imaging sequences in both quality and artifact size. Specifically, for optimized cine imaging a GRE sequence should be used with settings that favor short echo time, i.e. flow compensation off, weak asymmetrical echo and a relatively high receiver bandwidth. For static black-blood imaging, a TSE sequence should be used with fat saturation turned off and high receiver bandwidth.

Image Quality of Cardiac Magnetic Resonance Imaging in Patients With an Implantable Cardioverter Defibrillator System Designed for the Magnetic Resonance Imaging Environment

“…In another small cohort of patients with metal implants of various origin, a better image quality of CMR was found for FGE acquisitions in comparison with SSFP. 13 These findings and the results of the current study are in agreement with the fact that the SSFP sequence is more susceptible to field inhomogeneities than the FGE sequence. Importantly, many pulse sequences used in clinical MRI practice for viability/scar imaging, 14 myocardial perfusion imaging, [15][16][17][18] tagging, 19 and flow measurements 20 are using FGE-type readouts.…”

Advances in MRI around metal

“…Besides orthopedic implants, other applications of MARS sequences in the presence of metal implants include radiotherapy planning close to implants, cerebral MRI in the presence of intracranial aneurysm clips, cardiac imaging, odontics, and breast imaging . However, these fields are not covered in this review.…”

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

“…All patients had a contrast‐enhanced magnetic resonance angiogram (MRA) performed with sequence parameters optimized by patient size (FOV 240–330 × 320–440 mm, matrix 211 × 230 – 352 × 384 pixels, PAT 2–3, res 0.9–1.1 mm isotropic, TE 1.07–1.16 ms, TR 3.12–3.29 ms, flip angle 25), a 3D steady‐state free precession (3DSSFP) dataset that was either respiratory‐navigated (FOV 210 × 320 mm, matrix 135 × 256 pixels, PAT 2, pixel 1.3 mm isotropic, TE 1.54 ms, TR 3.48 ms, flip angle 50) with a Cartesian acquisition or self‐navigated (FOV 220 × 220 mm, matrix 192 pixels, PAT 1, res 1.1 mm isotropic, TE 1.53 ms, TR 3.05 ms, flip angle 50) with a radial acquisition and velocity‐encoded MRI for measurement of blood flow. When appropriate, metal artifact‐reducing imaging protocols were used . The MRA and 3DSSFP images were inspected for overall quality as well as quality of the region of interest, and the optimal 3D dataset was segmented and used to create the XFM overlay.…”

“…Pre-catheterization CMR was performed immediately before the elective cardiac catheterization case in our combined interventional CMR (iCMR) suite. 7 8 The MRA and 3DSSFP images were inspected for overall quality as well as quality of the region of interest, and the optimal 3D dataset was segmented and used to create the XFM overlay.…”