256-slice Spiral CT Angiography In Arterial Erectile Dysfunction: A Penile Hemodynamic Study

Objective : To study the value of 256 slice spiral CT perfusion imaging in the diagnosis of arterial erectile dysfunction.Methods: Seventy-two adult male patients with arterial erectile dysfunction(study group) and twenty adult male subjects without arterial erectile dysfunction(control group) underwent 256-slice spiral CT perfusion scan of the lower abdomen.Three-dimensional images of the penile vessels were reconstructed by special software of 256-slice spiral CT perfusion imaging. Perfusion parameters of the arteries at the middle section of bilateral cavernous bodies (interest 5 mm2) of the penis, including time-to-peak (TTP; the time from the start of injection until maximum contrast enhancement is reached), blood flow (BF; measured in milliliters of blood flow per 100 grams of cavernous tissue of penis per minute), and blood volume (BV; measured in milliliters of blood volume per 100 grams of cavernous tissue) were collected and then conducted imaging and statistical analysis.Results: There were no significant differences in TTP, BF and BV between the bilateral cavernous arteries of the penis in the control group (P > 0.05). The continuity of bilateral cavernous body arteries was traceable on 256-slice CT angiography images. And the continuity of bilateral cavernous body arteries was also observed on the reconstructed three-dimensional images of the penile vessels. Unilateral cavernous body artery stenosis or occlusion was observed on CT images of 63 cases from the study group (left side 36 cases and right side 27 cases),and bilateral cavernous body artery were not visualized in the remaining 9 cases from the study group. By reconstructing the three-dimensional images of the penile vessels with special software and studying the hemodynamic of penis cavernous body perfusion, we found that there were significant differences in TTP,BF and BV between bilateral cavernous body arteries in these 63 cases (P < 0.05). The perfusion parameters (TTP, BF and BV)were also significantly different between stenotic cavernous body arteries of the study group and the control group (P < 0.05). Bilateral cavernous body artery were not visualized in the remaining 9 cases from the study group. Nonvisualization of bilateral cavernous body arteries was traceable on reconstructed three-dimensional images of the penile vessels of these 9 cases.Conclusion: Three-dimensional images of the penile vessels are reconstructed using 256-slice spiral CT angiography data and the related perfusion parameters can help to study penile hemodynamic,at the same time can better show the lesion of penis vessel.The 256-slice spiral CT angiography caused minor injury and lower cost less than the other inspection means,and pioneered a new method for diagnosis of arterial erectile dysfunction.