Patient-adapted respiratory training: Effect on navigator-triggered 3D MRCP in painful pancreatobiliary disorders

To compare the image quality of navigator-triggered (NT) 3D MR cholangiopancreatography (MRCP) with and without a patient-adapted respiratory training, in clinical patients with painful pancreatobiliary disorders.

With institutional review board approval, hospitalized patients with painful pancreatobiliary disorders who were scheduled for MRCP study were prospectively enrolled. The numerical rating scale (NRS) of abdominal pain during the examination was recorded. Special patient-adapted respiratory training was conducted before the examination. A control group of patients was enrolled with the same criteria, who received ordinary instructions only (n=60 for each group). A subgroup of patients (n=10) underwent MRCP studies with ordinary instructions first and with patient-adapted training later. Acquisition time was recorded. General image quality, degree of artifacts and visualization of 12 segments of the pancreatobiliary tree were rated on a five-point scale and compared between the groups.

Both groups had similar NRS of pain. There was a significant improvement in image quality (p<0.01) as well as visualization of right posterior hepatic duct (p=0.045), left lateral hepatic duct (p=0.037), and pancreatic duct (p<0.01 for head, body and tail segments) in patients receiving respiratory training. The other segments showed no significant differences. The percentage of patients with severe and extensive imaging artifacts decreased from 18.3%(11/60) to 8.3%(5/60). The acquisition time was shorter (175±54s vs 249±67s, p<0.01) in patients with respiratory training.

Patient-adapted respiratory training improves the image quality of NT-MRCP in patients with painful pancreatobiliary disorders.