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Utility of dynamic MRA in the evaluation of male erectile dysfunction

  • Alexandra RoudenkoEmail author
  • Rand N. Wilcox Vanden Berg
  • Christopher Song
  • Martin R. Prince
  • Darius A. Paduch
  • Daniel Margolis
Special Section: Male pelvis

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.

Keywords

Erectile dysfunction MR angiography Time-resolved MRA Venous leak Dynamic MRA 

Notes

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyMount Sinai Health SystemNew YorkUSA
  2. 2.Department of RadiologyWeill Cornell MedicineNew YorkUSA
  3. 3.Department of UrologyWeill Cornell Medicine/New York PresbyterianNew YorkUSA
  4. 4.Arthur Smith Institute for UrologyNorthwell HealthGreat NeckUSA
  5. 5.Bioimaging LabConsulting Research Services, IncNorth BergenUSA

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