Ultrasound and MRI in the diagnosis of penile induration (Peyronie's Disease)

Abstract

Penile induration, a disease of connective tissue, requires the precise delineation and differentiation of inflammatory changes (plaques) for accurate therapy. Seventy two patients with clinically suspected Induratio penis plastica (IPP) underwent ultrasound examination between 1984 and 1991. In 37 patients (aged 18 to 80) the diagnosis was proven by ultrasound. Out of this group 27 patients were examined with magnetic resonance imaging (MRI), 15 of them with additional intravenous application of adolinium DTPA (Gd-DTPA). All examinations were performed within four weeks. The results showed, that ultrasound was able to detect plaques and changes of the tunica albuginea in all 37 cases, but MRI was more sensitive in the detection of possible inflammatory change (T2-prolongation and moderate Gd-DTPA enhancement in gradient-echo sequences.

MRI revealed inflammatory changes in 22 of 27 examined patients while ultrasound detected only nine such cases out of 37. Ultrasound is the method of choice in diagnosing IPP, due to the overall sensitivity to plaques and changes in the tunica. On the other hand MRI offers valuable additional information with respect to inflammatory changes particularly after Gd-DTPA. Therefore MRI has the potential to improve therapeutic planning and should be used in monitoring therapeutic effects.