Dynamic contrast-enhanced MRI study of male pelvic perfusion at 3T: Preliminary clinical report

Purpose: To detect male pelvic perfusion in patients with coronary artery disease (CAD) vs. controls by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) at 3T. Materials aad Methods: Eighteen male patients were studied with T1-weighted (TIW) DCE-MRI to measure perfusion, phase-contrast (PC) imaging to measure bulk flow, and contrast-enhanced (CE)-MRA to detect stenosis. Regions of interest (ROIs) in prostate, corpus cavemosal, and spongiosal tissues were analyzed. Two-compartment pharmacokinetic modeling was employed to fit the signal enhancement. Perfusion parameters were analyzed by curve-fitting and utilized to compare the CAD and control groups. Validated questionnaires measuring urinary and erectile function were used to evaluate pelvic symptomatology in both groups. Results: Mean perfusion analysis confirmed weaker and slower enhancement In CAD patients vs. controls despite equivalent cardiac output values. The mean maximum enhancement was 26.33 ± 0.12 (controls) vs. 22.38 ± 0.44 (CAD) for prostate. The mean wash-in rate in units of minute^-1 was 62.10 ± 1.74 (controls) vs. 34.44 ± 1.08 (CAD) for prostate, 16.68 ± 0.72 (controls) vs. 8.04 ± 0.36 (CAD) for spongiosal, and 8.34 ± 0.54 (controls) vs. 3.48 ± 0.24 (CAD) for cavernosal tissues (all with P < 0.0001). Conclusion: This preliminary study demonstrates that perfusion parameters differ between CAD and control patients, and the findings mirror the differences in pelvic symptoms in these groups.