Uder Michael, Gohl Dietrich, Takahashi Masahide, Derouet Harry, Defreyne Luc, Kramann Bernhard, Schneider Günther
Department of Radiology, University Hospital, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany.
Eur Radiol. 2002 Jan;12(1):113-20. doi: 10.1007/s003300101051. Epub 2001 Jul 24.
A rupture of corpus cavernosum (CC) is a rare injury of the erect penis. The present study describes the role of MRI for diagnosis and follow-up of this injury. Four patients with clinically suspected acute penile fractures underwent MRI. Imaging findings were confirmed at surgery. In three patients, follow-up MRI was also available at 1, 6 and 16 weeks after surgical repair. In all patients pre-contrast T1-weighted images (T1WI) clearly disclosed ruptures of CC, which depicted as discontinuity of low signal intensity of the tunica albuginea (TA). Concomitant subcutaneous haematoma were well visualised both on T1-weighted (T1WI) and T2-weighted images, whereas haematoma in CC were optimally demonstrated on contrast-enhanced T1WI. On follow-up MRI all fractures presented similar healing process. Shortly after the repair, the tunical suture showed an increase in signal intensity on pre-contrast T1WI and was strongly enhanced with the administration of contrast material. Then the tear site gradually recovered low signal intensity on all spin-echo sequences by 4 months after surgery. These serial findings may suggest the formation of vascularised granulation tissue during cicatrisation. Magnetic resonance imaging is of great value for the diagnosis and follow-up in patients with penile fracture.
阴茎海绵体破裂是勃起阴茎的一种罕见损伤。本研究描述了MRI在该损伤诊断及随访中的作用。4例临床疑似急性阴茎骨折的患者接受了MRI检查。影像学表现经手术证实。3例患者在手术修复后1周、6周和16周也进行了随访MRI检查。在所有患者中，增强前T1加权像（T1WI）清晰显示阴茎海绵体破裂，表现为白膜低信号的连续性中断。同时，皮下血肿在T1加权像（T1WI）和T2加权像上均清晰可见，而阴茎海绵体内的血肿在增强T1WI上显示最佳。随访MRI显示所有骨折愈合过程相似。修复后不久，白膜缝线在增强前T1WI上信号强度增加，注射对比剂后强化明显。术后4个月，撕裂部位在所有自旋回波序列上逐渐恢复为低信号强度。这些系列表现可能提示瘢痕形成过程中血管化肉芽组织的形成。磁共振成像对阴茎骨折患者的诊断及随访具有重要价值。
