Visualization of the Eustachian Tube Cartilage on Delayed Contrast-enhanced 3D-MR Imaging: A Preliminary Comparison between Ionic and Non-ionic Gadolinium-based Contrast Agents
Year: 2026
Type: article
Abstract: PURPOSE: To evaluate whether delayed contrast-enhanced 3D MRI using a non-ionic gadolinium-based contrast agent enables reliable visualization of the Eustachian tube cartilage (ETC) and to compare the signal intensity characteristics between ionic and non-ionic contrast agents. METHODS: Thirty-five participants underwent 3T fat-suppressed 3D-Motion-Sensitized Driven-Equilibrium (MSDE) T1-weighted MRI 4 hr after receiving either gadobutrol (non-ionic, n = 18) or gadoterate meglumine (ionic, n = 17). The visualization of the ETC was qualitatively evaluated using a 5-point Likert scale by 2 neuroradiologists. Signal intensity ratios relative to the medulla were measured for the ETC, nasal turbinate mucosa, and lateral pterygoid muscles. Semi-automated 3D segmentation of the ETC was performed in representative cases. RESULTS: The inter-observer agreement for the qualitative scores was substantial (κ = 0.786-0.808). Qualitative ETC visual scores were significantly higher in the gadobutrol group than in the gadoterate meglumine group (median, 5.0 vs. 4.0; P < 0.001). The ETC-to-medulla signal intensity ratios were significantly higher with gadobutrol bilaterally (right: 1.52 ± 0.20 vs. 1.21 ± 0.19, P < 0.0001; left: 1.54 ± 0.26 vs. 1.24 ± 0.22, P = 0.00088). No significant differences were observed in control soft tissues. Furthermore, semi-automated 3D segmentation of the ETC was successfully achieved in representative cases using high-resolution MR datasets with a non-ionic contrast agent. CONCLUSION: Delayed contrast-enhanced 3D-MRI with a non-ionic contrast agent allows clear, high-contrast visualization and 3D reconstruction of the ETC, outperforming the ionic agents.
Institution: Nagoya University
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Awards: Early detection of pre-symptomatic conditions through evaluation of vascular permeability and waste excretion function in the brain and sensory organs, Revolutionizing the Diagnosis of Neurodegenerative Diseases by Elucidating the Final Exit for Waste Clearance from the Brain and Sensory Organs
OpenAlex ID: W7222341165