The Study Of Diagnostic Value Of Dual-energy CT Angiography For Arteriogenic Erectile Dysfunction

Objective:The purpose of this study was to investigate the diagnostic value of dual-energy CT arteriography(DE-CTA)as a novel non-invasive imaging method in patients with arteriogenic erectile dysfunction and analysis of medication in patients with sexual dysfunction.Methods:A total of 52 patients with suspected arteriogenic erectile dysfunction underwent examinations.Penile duplex Doppler ultrasonography(PDDU)was taken to evaluate penile hemodynamics,and the related values of peak systolic velocity(PS V),end diastolic velocity(EDV)and resistant index(RI)were measured.After the induction of an erection with prostaglandin E,DE-CTA was performed to obtain angiograms of the pelvis and penis.The evaluation of arterial system supplying the penis was accomplished on workstation with Multiple maximum Intensity Projection(MIP)and Volume Rendering(VR).Results:Finally,51 patients had pellvic images of qualified quality for evaluation,and 1 patient was excluded due to low quality of image.Among the 51 patients,23 patients were complicated with premature ejaculation,17 patients had been treated with drugs,among which 8 patients(47.06%)had been treated with western medicine only,3 patients(17.65%)had been treated with traditional Chinese medicine only,and 6 patients(35.29%)had been treated with combination of Chinese and western medicine.A total of 612 segments were finally obtained and 201 segments were considered as abnormal.The distribution was:2(1.0%)in common iliac artery segment,3(1.5%)in internal iliac artery,36(17.9%)in internal pudendal artery segment,38(18.9%)in penile artery segment,50(24.9%)in dorsal artery segment,and 72(35.8%)in cavernous artery The diagnostic accuracy,specificity,sensitivity,NPV and PPV of DE-CT were 90.20%,90.48%,88.89%,97.44%,and 66.67%.Conclusions:DE-CTA can detect macroangiopathy and delineate small vessels clearly,and thus can provide additional anatomic evaluation of arteries compared with PDDU.In terms of diagnostic value,DE-CTA has high diagnostic efficiency.Therefore,DE-CTA has the potential to be a novel and reliable method in the diagnosis of arteriogenic erectile dysfunction.