Diagnostic value of magnetic resonance imaging in Peyronie's disease--a comparison both with palpation and ultrasound in the evaluation of plaque formation.
OBJECTIVE
To compare the value of magnetic resonance imaging (MRI) with palpation and ultrasound in the evaluation of plaque formation in Peyronie's disease.


METHODS
57 patients underwent a standardized diagnostic procedure to evaluate plaque formation consisting of palpation and ultrasonography (7.5 MHz). MRI was performed during flaccidity and during erection induced by Prostaglandin E(1) including intravenous application of Gadolinium-diethylenetriaminepentaacetic acid (Gd-DPTA).


RESULTS
With all methods, 93 plaques have been detected in 57 patients. 85 plaques (91.4%) have been evaluated by palpation alone. Using ultrasound, 52 of these 93 plaques (55.9%) were detectable. This is equivalent to 61.1% of the palpable plaques. MRI confirmed 58 of the palpated plaques (68.2%) and exposed 8 primarily not palpable plaques at the penile basis. MRI revealed more palpable plaques than ultrasound, but this finding was not significant (p = 0.083). By means of sonography, calcification was evident in 14 plaques. MRI failed in revealing any calcification. After application of Gd-DPTA, 5 of 57 patients (9%) demonstrated contrast enhancement indicating local inflammation. None of these patients reported on penile pain.


CONCLUSIONS
Penile palpation in combination with ultrasound represents the method of choice to diagnose plaque formation in Peyronie's disease. MRI provides better information on plaque formation at the penile basis. Calcification can only be proven by ultrasound, not by MRI. There may be additional information by MRI about local inflammation. A prospective study comparing the histological and MRI findings should be performed to answer the question, if pain is really associated with inflammation.
Hauck
Ekkehard W
EW
Department of Urology, Justus Liebig University, Rudolf-Buchheim-Str 7, D-35385 Giessen, Germany.
Hackstein
Nils
N
Vosshenrich
Rolf
R
Diemer
Thorsten
T
Schmelz
Hans U
HU
Bschleipfer
Thomas
T
Schroeder-Printzen
Immo
I
Weidner
Wolfgang
W
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010173:Palpation; D010411:Penile Induration / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography