Assessement of Radiological Anatomy of Prostatic Artery on 3D DECT in Symptomatic Benign Prostatic Hypertrophy.

Background: Benign prostatic hyperplasia (BHP) is a common disease in the urinary system and often appears in old male patients with the incidence increasing proportionally to age.

Objective: The study aimed to describe the anatomy and imaging findings of the prostatic artery (PAs) on 3D rendering dual-energy multi-sequence computed tomography (DECT) in patients with symptomatic benign prostatic hypertrophy (BPH) treated by prostatic artery embolisation (PAE).

Methods: The study was conducted on 64 patients with BPH who underwent DECT scans with 3D rendering of the pelvic artery before intervention from August 2022 to November 2023. The PAs were independently evaluated for each side, focusing on the number of branches, origin, tortuosity, atherosclerotic plaque, and anastomoses with adjacent arteries.

Results: Among 128 pelvic sides where the PAs can be observed, the rate of finding 01 prostate artery on each side was high (96.1%), and the rate of 02 prostate arteries on each side was rare (3.9%). In 133 prostatic arteries, the most common type of prostatic artery according to origin is type I (29.6%), followed by type III (24.6%). The atherosclerotic prostatic artery rate is 24.6%, and the average diameter is 1.5±0.4 mm. The tortuosity prostate artery accounted for 74.6%. The anastomosis to the contralateral prostatic artery rate is 48.4%, followed by the penis and rectum anastomoses.

Conclusion: PAs have abundant original varies between the left and right sides and between patient to patient. The most common form arises from the internal pudendal artery.