Evaluation of Wideband Pulse Sequences for Suppressing Image Artifacts in Children with Cardiac Implantable Electronic Devices.

Purpose To determine whether wideband late gadolinium enhancement (LGE) and wideband perfusion pulse sequences suppress image artifacts in children in the presence of a cardiac implantable electronic device (CIED). Materials and Methods In the first experiment of this prospective study, unenhanced cardiac MRI was performed at 1.5 T in 18 healthy pediatric participants (median age, 12 years [range, 10-15 years]; 12 [67%] female) with and without a CIED generator taped in the subclavicular and abdominal positions. LGE and perfusion scans were performed with standard and wideband sequences in each state. Three clinical raters adjudicated the presence or absence of clinically relevant image artifacts. Image artifacts were also quantified. In the second experiment, wideband perfusion and LGE MRI scans with gadolinium-based contrast material administration were performed on four pediatric participants (median age, 15 years [range, 15-19 years]; three [75%] female) with CIEDs in situ. Image quality was graded on a five-point Likert scale by clinical raters (3 = clinically acceptable). Myocardial blood flow was also quantified. Results In the participant experiments, standard LGE produced image artifacts in 61.81% (178 of 288) and 37.15% (107 of 288) of myocardial segments for subclavicular and abdominal IPGs, respectively, and were significantly different (P < .001) from wideband LGE (14.68% [42 of 288] and 0%, respectively) for both positions. Quantitative analysis results were consistent with expert adjudication. Wideband cardiac MRI in four children with CIEDs achieved high image quality (median score ≥ 4.0) and mean resting myocardial blood flow value of 1.06 mL/min/g (n = 3). Conclusion Compared with standard LGE and perfusion MRI, wideband LGE and perfusion MRI produced significantly fewer image artifacts induced by CIEDs in pediatric participants. Keywords: Wideband, Pediatric, Late Gadolinium Enhancement, Perfusion, Pacemaker, Defibrillator Supplemental material is available for this article. © RSNA, 2025.