Highly Accelerated Real-time Cine MRI Pulse Sequence for Cardiac Implantable Electronic Devices and Arrhythmias

To compare the image quality and temporal resolution of a 32-fold accelerated real-time cine MRI pulse sequence (19.3-msec temporal resolution) with those of a previously described 16-fold accelerated Cartesian real-time cine sequence (39.8-msec temporal resolution) in patients with cardiac implantable electronic devices (CIEDs) and arrhythmias. This retrospective study included patients with CIEDs and arrhythmias scanned using both radial and Cartesian real-time cine MRI pulse sequences with gradient-recalled echo readouts at 1.5 T from March 2022 to March 2024. Image quality was assessed visually by clinical raters using a five-point Likert scale for each of four categories (namely, conspicuity, temporal fidelity of wall motion, artifact, and noise) and quantitatively using the signal-to-noise-and-artifact ratio metric. The authors used the Wilcoxon signed rank test and paired t test to compare differences for non-normally and normally distributed variables, respectively. The study included 23 patients with CIEDs and arrhythmias (nine female and 14 male patients; mean age, 66.5 years ± 13.3 [SD]). The radial real-time cine sequence yielded significantly higher median summed visual scores than the Cartesian real-time cine sequence across all myocardial segments (radial, 17.5–18, Cartesian, 14.5–16; P < .001). The mean signal-to-noise-and-artifact ratio was significantly higher for radial than for Cartesian (radial, 18.3 ± 5.6, Cartesian, 9.4 ± 4.1; P < .001). The proposed 32-fold accelerated radial real-time cine MRI pulse sequence provided higher temporal resolution and superior image quality than the 16-fold accelerated Cartesian real-time cine pulse sequence in patients with CIEDs and arrhythmias. Keywords: MR Imaging, Cardiac, Heart, Left Ventricle, Right Ventricle, Artifacts, Cardiac Assist Devices, Imaging Sequences, Radial K-Space, CIED, Arrhythmia, GRASP, Compressed Sensing, Real-Time, Freebreathing Supplemental material is available for this article.