Diagnostic value of four-dimensional CT angiography in arterial erectile dysfunction using 320-detector row dynamic volume CT

Biosci Rep. 2017 Aug 21;37(4):BSR20170200. doi: 10.1042/BSR20170200. Print 2017 Aug 31.

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.

Keywords: 320-row dynamic volume CT; Arterial erectile dysfunction; Diagnosis; Four-dimensional CT angiography; Sensitivity; Specificity.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Angiography
  • Arteries / diagnostic imaging*
  • Arteries / pathology
  • Cone-Beam Computed Tomography / methods*
  • Four-Dimensional Computed Tomography / methods*
  • Humans
  • Impotence, Vasculogenic / diagnostic imaging*
  • Impotence, Vasculogenic / pathology
  • Male
  • Middle Aged
  • Penis / blood supply
  • Penis / pathology
  • ROC Curve
  • Regional Blood Flow
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Color