Gadolinium-enhanced magnetic resonance angiography of the pelvis in patients with erectile impotence |
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Authors: | Michael K Stehling Libin Liu Gerhard Laub Kurt Fleischmann Ulrike Rohde |
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Affiliation: | (1) Radiologic Institute, Schubaurstr 8A, 81245 Munich, Germany;(2) Siemens Medical Systems, Erlangen, Germany;(3) Urologic Practice, Schubaurstr. 8A, 81245 Munich, Germany |
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Abstract: | This study evaluted the potential of contrast-enhanced digital-subtraction magnetic resonance angiography (CE-DS-MRA) for
noninvasive angiographic delineation of the arterial supply of the penis in patients with erectile dysfunction. After induction
of an erection with prostaglandin E, a three-dimensional fast imaging with steady-state precision (FISP) sequence with TE
of 1.8–2 milliseconds, TR of 4.4–5 milliseconds, and flip angle of 40°–60° was used to obtain high-resolution angiograms of
the pelvis and penis during the injection of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) 0.3 mmol/kg body weight,
within 30–50 seconds. DS maximum intensity projections (MIPs) and multiplanar reconstructions (MPRs) were compared with clinical
work-up and directional Doppler ultrasound in 11 patients. In all 11 patients (100%), the arterial supply of the penis could
be delineated from the aortic bifurcation via the iliac and internal pudendal arteries to the dorsal and deep penile arteries.
Of the 22 internal pudendal arteries, 6 (27%) were occluded on CE-DS-MRA and 5 (23%) had stenoses, of which 4 (18%) were greater
than 50%. In 7 patients (64%) good correlation between CE-DS-MRA and clinical findings and/or Doppler ultrasound was found;
in 2 patients (18%), the correlation was moderate, and in 2 patients (18%) results were discrepant. In 6 patients (55%), MRA
provided additional information to the clinical and Doppler ultrasound work-up. CE-DS-MRA can delineate small sessels such
as the internal pudendal and penile arteries and thus has the potential to become a noninvasive angiography method in the
work-up of erectile impotence.
Supported by Siemens Medical Systems, Erlangen; Schering AG, Berlin; and Agfa-Gevaert AG, Leverkusen. |
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Keywords: | erectile impotence angiography magnetic resonance imaging (MRI) magnetic resonance angiography (MRA) contrast-enhanced MRA |
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