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Utility of dynamic MRA in the evaluation of male erectile dysfunction

  • Special Section: Male pelvis
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Radiology, Mount Sinai Health System, 1000 10th Ave, New York, NY, 10019, USA

    Alexandra Roudenko

  2. Department of Radiology, Weill Cornell Medicine, 1305 York Ave, New York, NY, 10021, USA

    Christopher Song, Martin R. Prince & Daniel Margolis

  3. Department of Urology, Weill Cornell Medicine/New York Presbyterian, 525 E 68 St, New York, NY, 10065, USA

    Rand N. Wilcox Vanden Berg

  4. Arthur Smith Institute for Urology, Northwell Health, 1000 Northern Blvd, Ste 120, Great Neck, NY, 11021, USA

    Darius A. Paduch

  5. Bioimaging Lab, Consulting Research Services, Inc, North Bergen, NJ, USA

    Darius A. Paduch

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  1. Alexandra Roudenko
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  2. Rand N. Wilcox Vanden Berg
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  3. Christopher Song
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Correspondence to Alexandra Roudenko.

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Roudenko, A., Wilcox Vanden Berg, R.N., Song, C. et al. Utility of dynamic MRA in the evaluation of male erectile dysfunction. Abdom Radiol 45, 1990–2000 (2020). https://doi.org/10.1007/s00261-019-02339-y

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  • DOI: https://doi.org/10.1007/s00261-019-02339-y

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