Abstract: 【Objective】 To assess the imaging features and diagnostic value of multi-slice computed tomography (CT) enhanced scanning in patients with cardiac lead perforation. 【Methods】 Cardiac CT findings in 10 cases with pacemaker or implantable cardioverter-defibrillators lead perforation were analyzed

including the efficacy of CT for visualization of lead perforation

the precise location of the perforated lead tips

and the streaking artifacts and acoustic shadowing from the metallic lead. 【Results】 Five patients received conventional CT enhanced scan alone

and another 5 received ECG-gated enhanced scan followed by delayed enhancement. Among the 10 cases

only 1 case can be confirmed lead perforation by chest x-ray

and echocardiographic findings are equivocal in 6 patients. By CT scan

5 cases with probable and another 5 with definitelead perforation were documented

with 7 perforating in right ventricular apex

2 in right ventricular diaphragmatic surface

and 1 inright atrial posterior wall.There were 8 cases with small to large pericardial effusion

2 cases with no pericardial effusion. There was no contrast-medium found external leakage to the pericardial cavity in 5 patients with delayed enhancement scan. Among 10 patients accepted conventional CT scan(including 5 cases with delayed enhancement following ECG gating)

all cases produced motion artifacts of wired and lead tip

9 cases with moderate to severe metal artifacts of wired

1 case with no metal artifact of wired

and 8 with moderate to severe metal artifacts of lead tip

2 with mild metal artifacts of lead tip. Meanwhile

among 5 patients with ECG-gated scan

there was no case with motion artifact of wired and lead tip

2 cases with mild metal artifacts of wired

3 cases with no metal artifact of wired

4 cases with mild metal artifacts of lead tip

1 case with moderate metal artifact of lead tip. 【Conclusion】 Multi-slice CT can be a helpful adjunct to other imaging facilities in the diagnosis of lead perforation. Contrast-enhanced CT scan with ECG gatingmay improve the diagnostic accuracy due to its reduction of artifacts of lead and its tip.