Learning objectives
To discuss clinical situations with vascular impairment affecting the penis.
To depict Time-Resolved MRA (TR-MRA) technique for evaluation of these conditions.
To illustrate the impact of TR-MRA for choosing subsequent treatments.
Background
Penile Doppler ultrasound remain the mainstay of imaging investigation for vascular pathology affecting the penis.
However,
Time-resolved MRA may demonstrate the branches of the internal iliac vessels,
showing pathology involving these vessels and can assist the plan for pelvic revascularization,
prior to conventional angiography.
Findings and procedure details
Normal anatomyof the penis
The penis is composed of three vascular cylinders.
There are two dorsally located corpora cavernosa and the single ventral midline corpus spongiosum.
Each cylinder is surrounded by a fibrous band,
the tunica albuginea.
The cavernosal bodiescommunicate with one another through holes in the intercavernosal septum.
The spongiosum may have different signal from the cavernosa because it is functionally a separate space and may have a different rate of vascular flow within its channels than do the cavernosa.
The primary source of...
Conclusion
TR-MRA is a technique with very high temporal and spatial resolution which allow to capture the multiple arterial,
mixed,
venous phase images during the passage of contrast agent through the penile vascular anatomy
The method is particularly useful for planning vascular intervention
Careful study planning and multidisciplinary approach is key to perform and report TR-MRA studies.
References
MRI of the Penis; A.
Kirkham,
The British Journal of Radiology 2012,
85:S86 - S93
MR Imaging of Nonmalignant Penile Lesions; A.
Kirkham,
R.
Illing,
S.
Minhas,
C.
Allen,
RadioGraphics 2008;28:837-853
MR Imaging of the Penis; E.
Pretorius,
E.
Siegelman,
P.
Ramchandani,
M.
Banner,
RadioGraphics 2001 21:suppl_1,
S283-S298