H. John et al., Clinical value of pelvic and penile magnetic resonance angiography in preoperative evaluation of penile revascularization, INT J IMPOT, 11(2), 1999, pp. 83-86
Penile angiography is invasive, costly and requires postinterventional surv
eillance. The aim of this pilot study was to determine whether three dimens
ional magnetic resonance (3D-MR)-angiography may replace conventional penil
e angiography in preoperative planning of penile revascularization. Twelve
patients with a mean age of 39 (21 - 59) y were evaluated. All patients und
erwent evaluation with intracavernous pharmacotesting, color Doppler sonogr
aphy (CDS), digital subtraction angiography (DSA) and pelvic MR-angiography
with gadolinium diethylene-triaminepentaacetic acid (Gd-Dota) 0.2 - 0.3 mm
ol/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 now 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 angi
ography remains the 'gold standard' for preoperative planning of revascular
ization procedures.