Optimized cardiac magnetic resonance imaging inversion recovery sequence for metal artifact reduction and accurate myocardial scar assessment in patients with cardiac implantable electronic devices

Figure 2 Effect of the improved inversion recovery sequence on removing late gadolinium enhancement hyperintensity artifacts and validation with an electroanatommic map. A: Conventional late gadolinium enhancement image showing metal hyperintensity artifact (arrows) from the implantable cardioverter defibrillator; B: The same image in (A) acquired with the improved late gadolinium enhancement sequence, which eliminated the artifact and revealed underlying scars (arrows); C: An electroanatommic map of the septal aspect of the right ventricle including the outflow tract. The map is a bipolar voltage map showing low voltage (< 1.5 mV) in the right ventricular outflow tract. The low voltage area (red color) corresponds nicely with the delayed enhancement localized in the septal aspect of the right ventricular outflow tract shown in (B)