Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging
Zepeng Ma, Xiaodan Zhang, Gaoyang Li, Shuangrui Yuan, Guangchao Yan, Zhaoxin Wang, Yongxia Zhao, Jianing Wang, Xiaoping YinABSTRACT
Background
In cardiac MRI, poor breath‐holding may lead to suboptimal image quality. However, the effect of different breath‐hold methods on image quality remains unknown.
Purpose
To explore the effect of respiratory training with different breath‐holding methods and identify the optimal technique for reducing respiratory motion artifacts in cardiac MRI.
Study Type
Prospective.
Population
A total of 93 patients undergoing cardiac MRI (64 men and 29 women; mean age of 48.9 ± 13.7 years).
Field Strength/Sequences
3T, single‐shot fast spin‐echo sequence, fast imaging employing steady‐state acquisition sequence, first‐pass perfusion sequence (fast gradient echo), and late gadolinium enhancement sequence (phase‐sensitive myocardial delayed enhancement).
Assessment
All patients undergoing cardiac MRI were divided into three groups: mouth‐breathing, nasal‐breathing, and nose‐clip. Respiratory‐gated monitoring diagrams, examination duration, and subjective and objective image quality assessments were compared.
Statistical Tests
One‐way ANOVA, Chi‐square test, Kruskal–Wallis H test, Kappa test. Statistical significance was set at p < 0.05.
Results
Evaluation of the cardiac MRI respiratory‐gated monitoring diagrams showed that the probability of good breath‐holding in the nose‐clip group was 96.7%, significantly higher than in the mouth‐breathing (64.5%) and nasal‐breathing groups (75.0%). There was no significant difference in examination duration among groups. Myocardial noise in the mouth‐breathing group was significantly higher than those in the other two groups (24.2 [18.3, 32.5] vs. 15.8 [12.5, 23.9]/19.2 [13.7, 24.4]); blood pool noise was significantly higher than in the nasal‐breathing group (34.6 [22.6, 42.9] vs. 24.9 [18.4, 33.8]). However, CNR did not significantly differ among the three groups ( p = 0.07). Subjective image quality scores were higher in the nose‐clip group than those in the other two groups (26 [86.7%] versus 16 [51.6%]/18 [56.3%]).
Data Conclusion
Optimized respiratory training can enhance breath‐holding performance and image quality in patients undergoing cardiac MRI. The use of a nose clip for assisted breath‐holding was found to be the most effective method.
Evidence Level
2.
Technical Efficacy
Stage 2.