Magnetic resonance imaging as a potential tool for objective visualization of venous leakage in patients with veno-occlusive erectile dysfunction

Duplex Doppler ultrasonography (DDU) and dynamic infusion pharmacocavernosometry are the conventional diagnostic methods currently used to assess veno-occlusive hemodynamic status of patients with erectile dysfunction (ED). Dynamic infusion pharmacocavernosography is the standard method for demonstrating and visualization of venous leakage. To assess the potential application and utility of magnetic resonance imaging (MRI) in demonstrating and visualizing veno-occlusive dysfunction in patients with ED. A total of 28 patients, (32–56 years of age; mean 43.4±7.2 years), with clinical symptoms of veno-occlusive ED participated in this study. All patients have undergone DDU and dynamic infusion pharmacocavernosometry and pharmacocavernosography to assess presence of venous leakage. Patients were then evaluated with MRI and enhancement by intracavernous injection of paramagnetic contrast agent and erection was induced by intracavernosal injection of pharmacological agents. Diagnosis of ED patients with venous leakage was confirmed in all 28 patients using DDU and dynamic infusion cavernosometry-cavernosography (DICC). Venous leakage was documented by conventional DICC in 21 of 28 patients (75%). Veno-occlusive dysfunction in all patients was also assessed by MRI to localize distal, proximal or mixed locations of draining veins from the corpora cavernosa. MRI visualized venous leakage patients, in which DICC did not confirm venous leakage. MRI may be a useful diagnostic tool for assessing veno-occlusive dysfunction in ED patients and may improve diagnosis of venous leakage visualization.