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Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging.

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Τίτλος: Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging.
Συγγραφείς: Ma Z; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.; Hebei Key Laboratory of Precise Imaging of Inflammation Related Tumors, Baoding, China., Zhang X; Department of Ultrasound, Affiliated Hospital of Hebei University, Baoding, China., Li G; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Yuan S; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Yan G; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Wang Z; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Zhao Y; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Wang J; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China., Yin X; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.
Πηγή: Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2026 Oct; Vol. 64 (4), pp. 987-995. Date of Electronic Publication: 2026 Jun 29.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 9105850 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-2586 (Electronic) Linking ISSN: 10531807 NLM ISO Abbreviation: J Magn Reson Imaging Subsets: MEDLINE
Imprint Name(s): Publication: <2005-> : Hoboken , N.J. : Wiley-Liss
Original Publication: Chicago, IL : Society for Magnetic Resonance Imaging, c1991-
Ιατρικοί όροι (MeSH): Magnetic Resonance Imaging*/methods , Heart*/diagnostic imaging , Breath Holding* , Breathing Exercises*, Image Enhancement/methods ; Image Processing, Computer-Assisted/methods ; Humans ; Female ; Middle Aged ; Male ; Prospective Studies ; Adult ; Artifacts ; Reproducibility of Results ; Respiration ; Contrast Media
Περίληψη: 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.
(© 2026 International Society for Magnetic Resonance in Medicine.)
References: J Multidiscip Healthc. 2025 Feb 12;18:787-799. (PMID: 39963324)
Eur Radiol. 2022 Jul;32(7):4340-4351. (PMID: 35184220)
J Cardiovasc Magn Reson. 2021 Nov 8;23(1):126. (PMID: 34743718)
J Cardiovasc Magn Reson. 2018 Mar 8;20(1):16. (PMID: 29514708)
J Gen Intern Med. 2022 Apr;37(5):1226-1232. (PMID: 35137298)
Radiology. 2021 Sep;300(3):539-548. (PMID: 34128724)
J Clin Med. 2024 Jan 28;13(3):. (PMID: 38337447)
J Magn Reson Imaging. 2011 Jul;34(1):211-9. (PMID: 21618337)
Magn Reson Med. 2019 May;81(5):3234-3244. (PMID: 30474151)
Eur Radiol. 2016 Aug;26(8):2714-22. (PMID: 26573682)
BMC Cardiovasc Disord. 2021 Dec 7;21(1):580. (PMID: 34876015)
Curr Med Imaging. 2023;19(9):1090-1095. (PMID: 36453485)
Radiology. 2023 Jan;306(1):47-53. (PMID: 35997609)
Diagn Interv Imaging. 2023 Nov;104(11):538-546. (PMID: 37328394)
Neuroimage. 2021 Apr 15;230:117756. (PMID: 33460797)
Korean J Radiol. 2021 Jul;22(7):1044-1053. (PMID: 33856138)
Eur Radiol. 2023 Apr;33(4):2289-2300. (PMID: 36357691)
Front Cardiovasc Med. 2022 Apr 29;9:884221. (PMID: 35571164)
Rofo. 2018 Apr;190(4):341-347. (PMID: 29448290)
J Am Heart Assoc. 2022 Jan 4;11(1):e022605. (PMID: 34970923)
J Cardiovasc Magn Reson. 2016 Feb 25;18:10. (PMID: 26915830)
Ann Neurol. 2018 Mar;83(3):460-471. (PMID: 29420859)
Diagnostics (Basel). 2024 Sep 03;14(17):. (PMID: 39272732)
Magn Reson Imaging. 2018 Jan;45:43-50. (PMID: 28963048)
IEEE Signal Process Mag. 2020 Jan;37(1):111-127. (PMID: 33192036)
NMR Biomed. 2021 Feb;34(2):e4433. (PMID: 33258197)
Eur Radiol. 2018 Mar;28(3):1132-1139. (PMID: 28986630)
Int J Cardiovasc Imaging. 2019 Oct;35(10):1893-1901. (PMID: 31104178)
Eur Radiol. 2020 Nov;30(11):5923-5932. (PMID: 32556463)
Eur Radiol. 2024 Apr;34(4):2689-2698. (PMID: 37804340)
Magn Reson Med. 2021 Mar;85(3):1195-1208. (PMID: 32924188)
Clin Imaging. 2015 Jul-Aug;39(4):619-22. (PMID: 25555833)
Grant Information: 20231477 Medical Science Research Project of Hebei; 2023B03 Medical Science Foundation of Hebei University
Contributed Indexing: Keywords: breath‐holding effect; cardiac magnetic resonance; image quality; respiratory training
Local Abstract: [plain-language-summary] Cardiac MRI requires patients to hold their breath to prevent blurring from breathing motion, yet many patients struggle with this. This study compared three breath‐holding techniques in 93 patients: mouth‐breathing, nasal‐breathing, and using a nose clip. The nose clip achieved good breath‐holding in 96.7% of patients, versus 64.5% and 75.0% for the other methods and produced the highest image quality. The nose clip is a low‐cost tool requiring no equipment changes. These findings suggest that nose‐clip‐assisted breath‐holding is a practical, effective way to improve cardiac MRI quality in everyday clinical practice.
Substance Nomenclature: 0 (Contrast Media)
Entry Date(s): Date Created: 20260629 Date Completed: 20260916 Latest Revision: 20260918
Update Code: 20260918
PubMed Central ID: PMC13578530
DOI: 10.1002/jmri.70390
PMID: 42366921
Βάση Δεδομένων: MEDLINE
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  Data: Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ma+Z%22&quot;&gt;Ma Z&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.; Hebei Key Laboratory of Precise Imaging of Inflammation Related Tumors, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhang+X%22&quot;&gt;Zhang X&lt;/searchLink&gt;; Department of Ultrasound, Affiliated Hospital of Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Li+G%22&quot;&gt;Li G&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yuan+S%22&quot;&gt;Yuan S&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yan+G%22&quot;&gt;Yan G&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+Z%22&quot;&gt;Wang Z&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhao+Y%22&quot;&gt;Zhao Y&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+J%22&quot;&gt;Wang J&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yin+X%22&quot;&gt;Yin X&lt;/searchLink&gt;; Department of Radiology, Affiliated Hospital of Hebei University/Clinical Medical College, Hebei University, Baoding, China.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%229105850%22&quot;&gt;Journal of magnetic resonance imaging : JMRI&lt;/searchLink&gt; [J Magn Reson Imaging] 2026 Oct; Vol. 64 (4), pp. 987-995. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Jun 29.
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– Name: Abstract
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  Data: 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.&lt;br /&gt;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.&lt;br /&gt;Study Type: Prospective.&lt;br /&gt;Population: A total of 93 patients undergoing cardiac MRI (64 men and 29 women; mean age of 48.9 &#177; 13.7 years).&lt;br /&gt;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).&lt;br /&gt;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.&lt;br /&gt;Statistical Tests: One-way ANOVA, Chi-square test, Kruskal-Wallis H test, Kappa test. Statistical significance was set at p &amp;lt; 0.05.&lt;br /&gt;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%]).&lt;br /&gt;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.&lt;br /&gt;Evidence Level: 2.&lt;br /&gt;Technical Efficacy: Stage 2.&lt;br /&gt; (&#169; 2026 International Society for Magnetic Resonance in Medicine.)
– Name: Ref
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– Name: GrantInfo
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  Data: 20231477 Medical Science Research Project of Hebei; 2023B03 Medical Science Foundation of Hebei University
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  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;breath‐holding effect; cardiac magnetic resonance; image quality; respiratory training&lt;br /&gt;&lt;i&gt;Local Abstract: &lt;/i&gt;[plain-language-summary] Cardiac MRI requires patients to hold their breath to prevent blurring from breathing motion, yet many patients struggle with this. This study compared three breath‐holding techniques in 93 patients: mouth‐breathing, nasal‐breathing, and using a nose clip. The nose clip achieved good breath‐holding in 96.7% of patients, versus 64.5% and 75.0% for the other methods and produced the highest image quality. The nose clip is a low‐cost tool requiring no equipment changes. These findings suggest that nose‐clip‐assisted breath‐holding is a practical, effective way to improve cardiac MRI quality in everyday clinical practice.
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260629 &lt;i&gt;Date Completed: &lt;/i&gt;20260916 &lt;i&gt;Latest Revision: &lt;/i&gt;20260918
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20260918
– Name: PubmedCentralID
  Label: PubMed Central ID
  Group: ID
  Data: PMC13578530
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1002/jmri.70390
– Name: AN
  Label: PMID
  Group: ID
  Data: 42366921
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42366921
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/jmri.70390
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 987
    Subjects:
      – SubjectFull: Image Enhancement methods
        Type: general
      – SubjectFull: Image Processing, Computer-Assisted methods
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Prospective Studies
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Artifacts
        Type: general
      – SubjectFull: Reproducibility of Results
        Type: general
      – SubjectFull: Respiration
        Type: general
      – SubjectFull: Contrast Media
        Type: general
      – SubjectFull: Magnetic Resonance Imaging methods
        Type: general
      – SubjectFull: Heart diagnostic imaging
        Type: general
      – SubjectFull: Breath Holding
        Type: general
      – SubjectFull: Breathing Exercises
        Type: general
    Titles:
      – TitleFull: Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ma Z
      – PersonEntity:
          Name:
            NameFull: Zhang X
      – PersonEntity:
          Name:
            NameFull: Li G
      – PersonEntity:
          Name:
            NameFull: Yuan S
      – PersonEntity:
          Name:
            NameFull: Yan G
      – PersonEntity:
          Name:
            NameFull: Wang Z
      – PersonEntity:
          Name:
            NameFull: Zhao Y
      – PersonEntity:
          Name:
            NameFull: Wang J
      – PersonEntity:
          Name:
            NameFull: Yin X
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 10
              Text: 2026 Oct
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1522-2586
          Numbering:
            – Type: volume
              Value: 64
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Journal of magnetic resonance imaging : JMRI
              Type: main
ResultId 1