Feasibility of multi-slice computed tomography in the diagnosis of arteriogenic erectile dysfunction

Citation
Y. Kawanishi et al., Feasibility of multi-slice computed tomography in the diagnosis of arteriogenic erectile dysfunction, BJU INT, 88(4), 2001, pp. 390-395
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
BJU INTERNATIONAL
ISSN journal
1464-4096 → ACNP
Volume
88
Issue
4
Year of publication
2001
Pages
390 - 395
Database
ISI
SICI code
1464-4096(200109)88:4<390:FOMCTI>2.0.ZU;2-X
Abstract
Objective To compare computed tomography (CT) angiography (CTA) obtained by multi-slice CT (a new minimally invasive method) with the current standard of arterial imaging, digital subtraction angiography (DSA), in diagnosing arteriogenic erectile dysfunction (ED). Patients and methods Twenty-one patients with suspected arteriogenic ED und erwent DSA and CTA after providing informed consent. Prostaglandin El was i njected into the penile cavernosal body and then non-ionic contrast medium was rapidly infused into the antecubital vein. The DSA and CTA images were diagnosed as showing a normal or abnormal status by three reviewers indepen dently. CTA was undertaken on an outpatient basis but DSA required hospital ization. Results In the 42 internal pudendal arteries, DSA showed 28 normal and 14 i mpaired arteries: CTA showed 21 normal arteries and 21 occlusions. The CTA image correlated closely with the diagnosis of stenosis or occlusion in int ernal pudendal arteries, with a sensitivity or 93%, a specificity of 71%, a nd an accuracy of 79%. In the cavernosal arteries, DSA depicted 14 normal a nd 28 impaired arteries: CTA showed seven normal arteries and 35 occlusions . The CTA image agreed closely with the diagnosis of stenosis or Occlusion in cavernosal arteries, with a sensitivity of 96%, a specificity of 43% and an accuracy of 79%,. Of the 42 inferior epigastric arteries, DSA could not depict 11 arteries but CTA showed all 42 inferior epigastric arteries. Conclusions CTA images correlated with DSA images; at present DSA is better than CTA in visualizing stenosis in fine arteries. However. CTA is less in vasive and relatively inexpensive and in future will probably provide even greater improvements in graphic quality. CTA would be an adequate replaceme nt for DSA in evaluating internal pudendal arterial stenosis.