madman
Super Moderator
Abstract
Purpose To assess the efficacy of time-resolved MR angiography (MRA) in evaluating penile vasculature in patients with clinically suspected vascular anomalies contributing to their erectile dysfunction correlating with penile doppler ultrasound (PDUS) findings and clinical outcomes after surgical intervention.
Methods Men (n=26) with signs of early vascular shunting on PDUS underwent time-resolved, contrast-enhanced (0.1 mMol/kg gadobutrol at 1 ml/s followed by saline flush) 3-dimensional spoiled gradient echo T1-weighted MRA sequence performed over 3 min with 4.6 s frame rate after intracavernosal injection of an erectogenic agent. Additional T1- and T2-weighted sequences were performed for anatomic co-localization and tissue characterization. MRA images were evaluated for early filling of draining veins as well as arteriovenous malformations and fistulas and correlated with findings at surgery.
Results 29 MRA examinations on 26 patients (mean age 39 years) demonstrated abnormal early venous drainage (n=22) as well as diminutive/delayed cavernosal enhancement (n=3), incomplete tumescence (n=2), and combined arterial inflow/ venous outflow disease (n=1). The MRA had a concordance of 85.2% at determining the presence, or lack thereof of a shunt/AVM when compared to PDUS.
Conclusions Time-resolved MRA allows for both temporal and spatial resolution with visualization of both arterial and venous abnormalities which may be suggested with a screening PDUS examination. This technique allows us to provide detailed anatomic information prior to any surgical intervention.
In conclusion, dynamic MRA is a versatile non-invasive technique that allows for excellent temporal and spatial resolution with our customized protocol developed for evaluating penile vasculature and abnormal vascular processes contributing to patients' ED symptoms. Radiology can greatly assist in optimal surgical planning with findings on MRA confirming and at times adding to abnormalities suspected on PDUS.
Purpose To assess the efficacy of time-resolved MR angiography (MRA) in evaluating penile vasculature in patients with clinically suspected vascular anomalies contributing to their erectile dysfunction correlating with penile doppler ultrasound (PDUS) findings and clinical outcomes after surgical intervention.
Methods Men (n=26) with signs of early vascular shunting on PDUS underwent time-resolved, contrast-enhanced (0.1 mMol/kg gadobutrol at 1 ml/s followed by saline flush) 3-dimensional spoiled gradient echo T1-weighted MRA sequence performed over 3 min with 4.6 s frame rate after intracavernosal injection of an erectogenic agent. Additional T1- and T2-weighted sequences were performed for anatomic co-localization and tissue characterization. MRA images were evaluated for early filling of draining veins as well as arteriovenous malformations and fistulas and correlated with findings at surgery.
Results 29 MRA examinations on 26 patients (mean age 39 years) demonstrated abnormal early venous drainage (n=22) as well as diminutive/delayed cavernosal enhancement (n=3), incomplete tumescence (n=2), and combined arterial inflow/ venous outflow disease (n=1). The MRA had a concordance of 85.2% at determining the presence, or lack thereof of a shunt/AVM when compared to PDUS.
Conclusions Time-resolved MRA allows for both temporal and spatial resolution with visualization of both arterial and venous abnormalities which may be suggested with a screening PDUS examination. This technique allows us to provide detailed anatomic information prior to any surgical intervention.
In conclusion, dynamic MRA is a versatile non-invasive technique that allows for excellent temporal and spatial resolution with our customized protocol developed for evaluating penile vasculature and abnormal vascular processes contributing to patients' ED symptoms. Radiology can greatly assist in optimal surgical planning with findings on MRA confirming and at times adding to abnormalities suspected on PDUS.
Last edited:
