title: Clinical value of pelvic and penile magnetic resonance angiography in preoperative evaluation of penile revascularization.
abstract: Penile angiography is invasive, costly and requires postinterventional surveillance. The aim of this pilot study was to determine whether three dimensional magnetic resonance (3D-MR)-angiography may replace conventional penile angiography in preoperative planning of penile revascularization. Twelve patients with a mean age of 39 (21-59) y were evaluated. All patients underwent evaluation with intracavernous pharmacotesting, color Doppler sonography (CDS), digital subtraction angiography (DSA) and pelvic MR-angiography with gadolinium diethylene-triaminepentaacetic acid (Gd-Dota) 0.2-0.3 mmol/kg body weight. MR-angiography demonstrated the anatomy of the internal iliac arteries in 9 out of 12 patients. Intrapenile vessels were visible in 7 out of 12 patients. In comparison DSA provided complete visualization of all pelvic and penile vessels. Relevant arterial obstruction was found in 10 out of 12 patients. CDS revealed a mean maximal arterial flow of 27 (22-40) cm/s and showed in accordance to angiography arterial insuffiency in 10 out of 12 cases. Indication for revascularization could have been based on MR-angiography alone in only one patient. Therefore, selective penile angiography remains the 'gold standard' for preoperative planning of revascularization procedures.
authors.affiliation: Department of Urology, University Hospital Zurich, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: John
authors.forename: G M
authors.initials: GM
authors.lastname: Kacl
authors.forename: K
authors.initials: K
authors.lastname: Lehmann
authors.forename: J F
authors.initials: JF
authors.lastname: Debatin
authors.forename: D
authors.initials: D
authors.lastname: Hauri
mesh_terms: D000328:Adult; D000792:Angiography; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D006571:Heterocyclic Compounds; D006801:Humans; D018783:Impotence, Vasculogenic / Q000473:pathology* / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010413:Penis / Q000098:blood supply*; D011300:Preoperative Care; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate