Dynamic contrast-enhanced magnetic resonance imaging for distinguishing vital and non-vital teeth in jaw lesions: a pilot study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2026 Feb;141(2):239-244. doi: 10.1016/j.oooo.2025.09.019. Epub 2025 Oct 9.

Abstract

Objective: We evaluated the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (MRI) in distinguishing vital and non-vital teeth using a time-intensity curve pattern.

Study design: We retrospectively analyzed patients who underwent dynamic contrast-enhanced MRI examinations, including those with jaw lesions and vital test results. The vital status of the dental pulp was assessed using the electric pulp test. MRI was performed using a 3T scanner and a 16-channel head and neck coil, with intravenous administration of gadoterate meglumine. Two radiologists measured signal intensity using T1-weighted imaging, T2-weighted imaging, and gadolinium-enhanced T1-weighted imaging, while time-intensity curve classification was evaluated using time-resolved angiography with interleaved stochastic trajectory images.

Results: We analyzed 26 vital and 15 non-vital teeth, using the signal- and time-intensity curve classifications. Signal intensity measurements showed no significant differences between vital and non-vital teeth on T1-weighted imaging, gadolinium-enhanced T1-weighted imaging, and T2-weighted imaging. Time-intensity curve classification effectively distinguished between increasing- and non-increasing-type teeth. Only one case showed a discrepancy between the time-intensity curve and electric pulp test, but accuracy remained high at 98%.

Conclusion: Time-intensity curves derived from dynamic contrast-enhanced MRI accurately differentiated vital from non-vital teeth in jawbone lesions, comparable to the electric pulp test.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Meglumine
  • Middle Aged
  • Organometallic Compounds
  • Pilot Projects
  • Retrospective Studies
  • Tooth, Nonvital* / diagnosis

Substances

  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine