DOI: 10.1002/jmri.70423 ISSN: 1053-1807

Effect of Visualized Respiratory Training on Patient Cooperation and Image Quality in Gadoxetic Acid Disodium‐Enhanced Liver MRI : A Randomized Controlled Trial

Li Mei, Xin Luo, Bingyan Wang, Junfeng Wang, Chao Huang, Xuemei Hu, Qin Li, Wenyan Zhang

ABSTRACT

Background

Respiratory motion artifacts impair diagnostic accuracy in gadoxetic acid disodium (Gd‐EOB‐DTPA)‐enhanced liver MRI. Conventional verbal pre‐scan breathing training often yields inconsistent patient cooperation and image quality, creating an urgent clinical need for optimized training methods.

Purpose

To evaluate the impact of a visualized respiratory training method integrated into clinical workflow on patient cooperation, image quality, and examination efficiency for Gd‐EOB‐DTPA‐enhanced liver MRI.

Study Type

Prospective, single‐center, randomized controlled trial.

Population

One hundred and eighty‐four patients (135 males; mean age 53.5 ± 13.3 years) scheduled for first‐time Gd‐EOB‐DTPA‐enhanced liver MRI.

Field Strength/Sequence

3 T; Dynamic contrast‐enhanced imaging was performed with a 3D fast spoiled gradient‐echo sequence, covering pre‐contrast, arterial, portal venous, transitional, and hepatobiliary phases.

Assessment

Primary outcome was patient cooperation rate assessed by blinded MRI technologists. Secondary outcomes included motion artifact scores (rated by three blinded radiologists), Signal‐to‐Noise Ratio (SNR), Contrast‐to‐Noise Ratio (CNR), transient severe motion (TSM) incidence, and examination duration.

Statistical Tests

Student's t ‐test, Mann–Whitney U test, Chi‐square test, and Gamma correlation; two‐tailed p  < 0.05 indicated significance.

Results

The experimental group (85 patients) had a significantly higher full cooperation rate (56.5% [48/85] vs. 27.3% [27/99], OR = 3.46, 95% CI: 1.87, 6.40, γ  = 0.406), significantly lower motion artifact scores in arterial/portal venous/transitional phases, and significantly higher arterial and transitional phase SNR/CNR. The experimental group also showed significantly shorter preparation time (14.40 ± 2.36 vs. 16.16 ± 2.20 min; mean difference: −1.76 min; 95% CI: −2.42, −1.101). Scanning time did not differ significantly between groups (24.60 ± 1.60 vs. 24.89 ± 2.21 min; p  = 0.329). TSM incidence did not differ significantly between groups (1.18% vs. 5.05%, p  = 0.219).

Data Conclusion

Visualized respiratory training significantly improves patient cooperation, image quality, and workflow efficiency in Gd‐EOB‐DTPA‐enhanced liver MRI, with no additional resource requirements supporting its routine clinical adoption.

Evidence Level

2.

Technical Efficacy

Stage 1.

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