Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstr. 5, 40225, Dusseldorf, Germany.
Department of Urology, University Dusseldorf, Medical Faculty, Moorenstr. 5, 40225, Dusseldorf, Germany.
Sci Rep. 2024 Apr 2;14(1):7758. doi: 10.1038/s41598-024-58207-3.
Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal-Wallis test was applied for statistical analysis. Between April 2018 and March 2021, a total of 78 patients were included. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p < 0.001). We conclude that MRA could depict exact pelvic artery configuration, identify PA origin, and might obviate iliac CBCT. Vessel elongation of pelvic arteries increased intervention time and contrast media dose while the PA origin had no significant influence on intervention time and/or technical success.
关于解剖学细节的知识似乎有助于在有症状的良性前列腺增生 (BPS) 患者中进行前列腺动脉栓塞术 (PAE) 的手术规划。我们的研究目的是通过 MRA 对前列腺动脉 (PA) 进行术前可视化，并将髂骨伸长和分叉角度与 PAE 的技术成功率和技术参数相关联。回顾性分析接受 PAE 治疗的患者的 MRA 数据，分析 PA 可显影性、PA 类型、血管伸长和定义的角度与介入时间、透视时间、剂量面积乘积 (DAP)、累积空气比释动能 (CAK)、对比剂 (CM) 剂量和栓塞技术成功率之间的相关性。应用 T 检验、方差分析、皮尔逊相关和克鲁斯卡尔-沃利斯检验进行统计学分析。在 2018 年 4 月至 2021 年 3 月期间，共纳入 78 例患者。MRA 在 147 例中识别出 126 例 PA 起源（准确率为 86%）。血管伸长显著影响右侧 PA 导管插入时间（p=0.02）、透视时间（p=0.05）和 CM 剂量（p=0.02）。髂骨分叉角度与 DAP（左侧 r=0.30；右侧 r=0.34；p=0.01）和 CAK（左侧 r=0.32；右侧 r=0.36；p=0.01）之间存在中度相关性。比较患者前半段和后半段，介入时间（125 分钟与 105 分钟）和髂骨 CBCT 数量中位数可减少（p<0.001）。我们得出结论，MRA 可以描绘出精确的骨盆动脉形态，识别 PA 起源，并可能避免进行髂骨 CBCT。骨盆动脉的血管伸长增加了介入时间和对比剂剂量，而 PA 起源对介入时间和/或技术成功率没有显著影响。
