![]() ![]() MR imaging can demonstrate an intact TA and the presence of intracavernosal and extratunical haematoma. corpus spongiosum, urethra) can also be demonstrated ( 9, 11). Moreover, associated injuries to adjacent structures (eg. Moreover, because TA is well demonstrated as a low-signal intensity structure on T1 and T2 weighted images, MR imaging is optimal for the evaluation of the integrity of this anatomic structure even in patients with severe pain and swelling of penis as well as hematomas that appear as high signal intensity on both T1 and T2-weighted images ( 9, 10). Especially in patients that ultrasound is not conclusive, MR imaging can accurately depict the presence, location and extent of tunical tear which manifest as discontunity of TA ( 9). Some authors advocate cavernosonography to delinate the corporal rupture, but this invasive and painful procedure may increase heamatoma and involves ionizing radiation with a risk of infection and sometimes a lack image contrast.īecause of MRI multiplanar capabilty and excellent tissue contrast, it can be useful as a diagnostic tool in the evaluation of patients with acute penile fracture ( 8).īut MRI has also some limitations, such as higher cost than ultrasound, and readily not available everywhere. Other limitations of the sonography are that, edematous swelling of the penis and clots within the tear deteriorate the image contrast and can obscure the defect furthermore, a rupture in the pendilous area cannot be visualised. However this technique is operator dependent, and the major obstacle is a lack of tissue contrast ( 7). Sonography could be also a useful imaging modality for the diagnosis of penile fracture because it is easy to perform, noninvasive, widely available and unexpensive ( 6). Patients with atypical clinical findings may require a common diagnostic procedure. The diagnosis is usually not difficult and often is based on history and physical examination. In general the diagnosis of penile fracture is easily established clinically. Patients report hearing a snapping sound during the sexual act, followed by immediate pain and penile detumescence, in addition to the emergence of large edema, hematoma, and penile deformity ( 5). Penile fracture has a typical clinical presentation. Three patients have post traumatic erectil disfunction. In 11 patients a shortening and thickening of tunica albuginea was observed. Clinically all patients showed normal healing process without complications. The follow-up ranged from 3 months to 72 months. All patient underwent surgical exploration. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. Investigations were performed with 1.5T MR unit. Ten patients were injured during sexual intercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Between 19, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. ![]()
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