Pelvic Ischemia Is Measurable and Symptomatic in Patients with Coronary Artery Disease: A Novel Application of Dynamic Contrast-Enhanced Magnetic Resonance Imaging
Pelvic Ischemia Is Measurable and Symptomatic in Patients with Coronary Artery Disease: A Novel Application of Dynamic Contrast-Enhanced Magnetic Resonance Imaging
复制标题
DOI：
10.1111/j.1743-6109.2008.00969.x
复制
发表时间：
2008-11-01
影响因子：
3.5
通讯作者：
Westney, O. Lenaine
中科院分区：
文献类型：
--
作者：
De, Elise J. B.;Hou, Ping;Westney, O. Lenaine
盆腔缺血可表现为血管介导的勃起功能障碍（艾德）和下尿路症状（LUTS），并与心脏缺血相关。我们旨在开发一种动态对比增强磁共振成像（DCE-MRI）技术来测量良性组织的盆腔灌注。在3 T下使用T1加权DCE-MRI采集图像进行灌注。采用二室药代动力学模型拟合前列腺、海绵体和海绵体组织的信号增强，比较灌注参数和经验证的盆腔症状评分，CAD组的平均国际勃起功能指数（IIEF）总评分（41.3 ± 19.7）比对照组（59.4 ± 14.9，P = 0.04）差。CAD组IIEF勃起功能领域评分（13.7 ± 9.7）与对照组（22.0 ± 9.9，P = 0.09）相比有恶化趋势。CAD患者的平均国际前列腺症状总评分（IPSS）（13.2）比对照组（7.0）更差（P = 0.10）。磁共振灌注分析显示，与对照组相比，CAD组的平均最大增强百分比较低（P < 0.0001）：（22.4 ± 0.4）vs.对照组（26.3 ± 0.1）; CAD中的海绵体组织（9.3 +/- 0.2）与对照组（16.6 +/- 0.8）; CAD中的海绵组织（20.6 +/- 1.2）与对照组（24.0 +/- 0.6）。以10（-3）/秒为单位的平均洗入率的比较也非常显著（所有组织P < 0.0001）：CAD中的前列腺（574.0 ± 18.0）低于对照组（1 035.0 +/- 29.0）;在CAD海绵体组中，（58.0 +/- 4.0 vs.对照组139.0 +/- 9.0）和海绵组织（134.0 +/-6.0对比对照组中的278.0 +/-12.0）。这些初始数据表明可以在非癌组织中测量盆腔灌注，并且灌注与艾德和LUTS的有效测量相关。De EJB，Hou P，Estrera AL，Sdringola S，克雷默LA，Graves DE和Westney OL.冠状动脉疾病患者的盆腔缺血是可测量的和有症状的：动态对比增强磁共振成像的新应用J Sex Med 2008;5：2635-2645.
Pelvic ischemia can manifest as vascular-mediated erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), and is associated with cardiac ischemia.We aimed to develop a dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technique to measure pelvic perfusion in benign tissue.Nine men with coronary artery disease (CAD) were compared with nine without. Images were acquired at 3T with T1-weighted DCE-MRI for perfusion. Two-compartment pharmacokinetic modeling was employed to fit signal enhancement from prostate, corpus cavernosal, and spongiosal tissues.Perfusion parameters and validated pelvic symptom scores were compared.The mean International Index of Erectile Function (IIEF) total score was worse in CAD (41.3 +/- 19.7) vs. controls (59.4 +/- 14.9, P = 0.04). The IIEF erectile function domain score trended to worse in CAD (13.7 +/- 9.7) vs. controls (22.0 +/- 9.9, P = 0.09). The mean total International Prostate Symptom Score (IPSS) trended to worse in CAD patients (13.2) than controls (7.0) (P = 0.10). Magnetic resonance perfusion analysis demonstrated lower mean maximal percent enhancement to P < 0.0001 in the CAD group vs. controls for all the following comparisons: prostate in CAD (22.4 +/- 0.4) vs. controls (26.3 +/- 0.1); cavernosal tissue in CAD (9.3 +/- 0.2) vs. controls (16.6 +/- 0.8); and spongiosal tissue in CAD (20.6 +/- 1.2) vs. controls (24.0 +/- 0.6). Comparison of mean wash-in rates in the unit of 10(-3)/second was also highly significant (P < 0.0001 for all tissues): prostate in CAD (574.0 +/- 18.0) was lower than controls (1,035.0 +/- 29.0); slower wash-in rates were seen in CAD cavernosal (58.0 +/- 4.0 vs. 139.0 +/- 9.0 in controls) and spongiosal tissue (134.0 +/- 6.0 vs. 278.0 +/- 12.0 in controls).These initial data demonstrate that pelvic perfusion can be measured in noncancerous tissues, and that perfusion correlates with validated measures of ED and LUTS. De EJB, Hou P, Estrera AL, Sdringola S, Kramer LA, Graves DE, and Westney OL. Pelvic ischemia is measurable and symptomatic in patients with coronary artery disease: A novel application of dynamic contrast-enhanced magnetic resonance imaging. J Sex Med 2008;5:2635-2645.