2D and 3D T2-weighted MR sequences for the assessment of neurovascular bundle changes after nerve-sparing radical retropubic prostatectomy with erectile function correlation.
The aim of this study was to assess the capability of a 3D isotropic MRI T2-weighted sequence (3D T2 ISO) in the depiction of changes of neurovascular bundles (NVBs) after bilateral nerve-sparing radical retropubic prostatectomy (RRP). Furthermore, our aim was also to introduce a new MRI classification score of the NVB alteration patterns using the International Index Erectile Function Five-Item (IIEF-5) score as standard of reference. Fifty-three consecutive patients were postoperatively submitted to two MR examinations, including both 2D TSE T2-weighted (2D T2) and 3D T2 ISO sequences. Image findings were scored using a relative five-point classification and correlated with the postoperative IIEF-5 score. Radiologists attributed 13.2% of patients to class 0, 11.3% to class I, 34% to class II, 24.5% to class III, and 16.9% to class IV. With 3D T2 ISO images, the same radiologists determined 43.3% class 0, 32% class I, 11.4% class II, 7.5% class III, and 5.7% class IV. In all cases, the correlation and regression analysis between the 3D T2 ISO and IIEF-5 score resulted in higher coefficients values. The 3D sequence correlated most closely with patients' grading of erectile function.
Panebianco
Valeria
V
Department of Radiological Sciences, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy. valeria.panebianco@uniroma1.it
Sciarra
Alessandro
A
Osimani
Marcello
M
Lisi
Danilo
D
Ciccariello
Mauro
M
Salciccia
Stefano
S
Gentile
Vincenzo
V
Di Silverio
Franco
F
Passariello
Roberto
R
D000368:Aged; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply* / Q000276:immunology* / Q000473:pathology; D011468:Prostatectomy / Q000009:adverse effects*; D011631:Pubic Symphysis / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D016896:Treatment Outcome