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Objective: To investigate the feasibility and value of multi-slice spiral computed tomography angiography (CTA) in 3D imaging of internal pudendal arteries and their branches., Methods: Using 64-slice spiral computed tomography, we performed hypogastric CTA for 156 twenty to seventy years old males without vascular diseases. We assigned them to groups A (n = 83, 20 to 55 yr old) and B (n = 73, 56 to 70 yr old), and included 7 male patients with arterial erectile dysfunction (AED) aged 43 to 70 years in group C. We conducted maximum intensity projection (MIP), volume rendering (VR) and vascular analysis on the internal pudendal arteries and their branches, divided the MIP and VR images into 3 levels according to the resolution and continuity of the internal pudendal arteries and their branches for blind evaluation, and measured their diameters at various positions., Results: VR images of the internal pudendal arteries and their branches revealed significant differences between groups A and B (P<0.05), but not MIP images (P>0.05). There were no dramatic differences between MIP and VR in displaying internal pudendal arteries and their branches (P>0.05), nor any remarkable differences in the diameters of bilateral internal pudendal arteries and their branches at different levels in groups A and B (P>0.05). VR and MIP showed the 7 AED cases at grade III, and clearly revealed the degree and position of stenosis and occlusion in the internal pudendal arteries and their branches., Conclusion: CTA can display clear 3D images of internal pudendal arteries and their branches, and has a valuable role in the diagnosis and treatment of ED induced by internal pudendal artery diseases.

Selective pudendal arteriography is indicated in selected cases of male impotence when there is a strong presumption that peripheral arterial lesions are responsible for it. These lesions are classified as: (a) traumatic; (b) obstructive in thrombo-angiitis or atheroma, and (c) dysplasic. Selective arteriography will confirm the diagnosis and indicate the nature of the obstruction, its degree and extension.