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
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.
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BibTeX
@article{naganawa2026visualization,
title = {{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}},
author = {Shinji Naganawa and Rintaro Ito and Mariko Kawamura and Toshiaki Taoka and Masumi Kobayashi and Tadao Yoshida},
journal = {Magnetic Resonance in Medical Sciences},
year = {2026},
month = oct,
doi = {10.2463/mrms.tn.2026-0208},
url = {https://www.jstage.jst.go.jp/article/mrms/25/4/25_tn.2026-0208/_article},
note = {CC BY},
}
RIS
TY - JOUR
TI - 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
AU - Shinji Naganawa
AU - Rintaro Ito
AU - Mariko Kawamura
AU - Toshiaki Taoka
AU - Masumi Kobayashi
AU - Tadao Yoshida
PY - 2026
DA - 2026/10/16
JO - Magnetic Resonance in Medical Sciences
DO - 10.2463/mrms.tn.2026-0208
UR - https://www.jstage.jst.go.jp/article/mrms/25/4/25_tn.2026-0208/_article
AB - 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.
SN - 1880-2206
SN - 1347-3182
ER -