(262) Diagnosis of Corporal Veno-Occlusive Dysfunction Using Intravenous Contrast-Enhanced CT

Introduction Dynamic infusion cavernosometry and cavernosography (DICC) is the standard method for diagnosing corporal veno-occlusive dysfunction (CVOD) in patients with erectile dysfunction. However, it is highly invasive and available only at specialized centers. We have been investigating a novel diagnostic approach for CVOD using intravenous contrast-enhanced computed tomography (CECT). Objective In this study, we evaluated the diagnostic accuracy of this method. Methods Study subjects were 86 patients with suspected vasculogenic erectile dysfunction who underwent both CECT and DICC between April 2016 and March 2025. In CECT, contrast medium was administered intravenously, and intracavernosal CT values were measured in the early and delayed phases. The temporal enhancement ratio was calculated as the delayed/early phase ratio of intracavernosal CT value. Measurements were independently performed by three urologists, and the mean value was used for analysis. In DICC, CVOD was diagnosed when the flow-to-maintain (FTM) required to maintain an intracavernosal pressure of 90 mmHg was ≥20 mL/min. This study was approved by the institutional ethics committee (No. 10-020). Results The temporal enhancement ratio of the intracavernosal CT value was significantly higher in patients diagnosed with CVOD by DICC than in those without CVOD (median 1.273 vs. 1.591, p < 0.001, Mann–Whitney U test). Receiver operating characteristic (ROC) curve analysis demonstrated that an enhancement ratio cutoff value of 1.500 yielded a sensitivity of 66.0% and a specificity of 82.1% (area under the curve, 0.742; 95% CI, 0.634–0.851). Conclusions In patients with CVOD, the intracavernosal CT value increased over time during intravenous contrast-enhanced CT. This finding suggests that CECT can be used to diagnose CVOD. As a less invasive and more convenient alternative to DICC, this method may provide a valuable diagnostic option for patients with erectile dysfunction. Disclosure No