Abstract
The present study aims to evaluate the diagnostic value of four-dimensional CT angiography (4D-CTA) in the diagnosis of arterial erectile dysfunction (ED) using 320-detector row dynamic volume CT. Arterial ED patients attributed to arterial insufficiency were enrolled. To induce penile erection, an intracavernous injection (ICI) of corpus cavernosum with a vasoactive drug was administered. Patients were assigned into the erection hardness score (EHS) 1/2 group or EHS 3/4 group. Color duplex Doppler ultrasound (CDDU) was used to analyze blood flow spectrum. Each patient was examined using 4D-CTA. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of 4D-CTA in arterial ED. According to Irwin Goldstein, the EHS 3/4 group (n=38) had a shorter course of ED and low proportion with history of hypertension, hyperlipidemia, and diabetes than the EHS 1/2 group (n=35). The peak systolic velocity (PSV), end diastolic velocity (EDV), and resistant index (RI) in the EHS 3/4 group were lower than those of the EHS 1/2 group. 4D-CTA showed there were a total of 35 cases in the EHS 1/2 group (two cases missed) and 38 cases in the EHS 3/4 group (seven cases misdiagnosed). Using 4D-CTA to diagnose arterial ED, the area under the ROC curve yielded a value of 0.879, with a specificity of 93.9% and a sensitivity of 82.5%. These findings indicated that 4D-CTA using 320-detector row dynamic volume CT is a promising and reliable utility in diagnosing arterial ED.
Highlights
Erectile dysfunction (ED) is defined as the inability to reach potential or maintain a full erection required for satisfying sexual performance [1]
The inclusion criteria were as follows: patients had low or no erection ability as tested by nocturnal penile tumescence (NPT) and audiovisual sexual stimulation (AVSS); arterial ED patients diagnosed by color duplex Doppler ultrasound (CDDU) with peak systolic velocity (PSV) < 35 cm/s [18]
The present study aimed to investigate the effectiveness of four-dimensional CT angiography (4D-CTA) in the diagnosis of arterial ED using 320-detector row dynamic volume CT
Summary
Erectile dysfunction (ED) is defined as the inability to reach potential or maintain a full erection required for satisfying sexual performance [1]. ED is multifactorial and the causes may include neurogenic disorders, cavernosal disorders (peyronie’s disease), psychological disorders (performance anxiety, stress, and mental disorders), surgery, and aging [3,4,5,6,7]. As for the diagnosis of ED, color duplex Doppler ultrasound (CDDU) is of great significance in identifying the most appropriate therapy [8]. Poor reproducibility is considered as the main bias of penile artery dynamic Doppler examination, and psychological issues are considered to be mainly responsible for the aforementioned [9]. Due to lack of standardized measures, it is difficult to obtain accurate clinical diagnosis of a patient undergoing hemodynamic assessment of the penis by CDDU [8]. Due to the complexity of ED and inadequate availability of studies, there are still many limitations to our understanding of ED [10]
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