[Computerized tomography in Peyronie's disease. Clinico-radiological comparison].

The diagnostic capabilities of Computed Tomography (CT) in the study of Peyronie's disease are assessed. Twenty-four patients, with different symptoms and a variety of findings on physical examination (from normal to large painful plaques), were studied with third-generation CT equipment. CT defined the normal pattern of the albuginea, as a hyperdense (ranging from 80 to 100 HU) thin and regular line on the periphery of the corpora cavernosa. Pathologic features such as irregularities, disruptions and calcifications of the tunica can be identified; irregularities are shown as circumscribed zones of hyper or hypodensity, disruptions as small or large areas of complete absence of the thin regular line of albuginea. Calcifications are identified as hyperdense nodular or plaquelike areas of 200-300 HU. When physical examination and CT patterns are compared, the reliability of the method is revealed. It provides an accurate definition of the albugineal lesions, imaging all abnormalities detected on physical examination and demonstrating additional, non-palpable and doubtful lesions. Physical examination and CT findings concurred in 19 cases (79%), whereas disagreement was observed in 5 (12%). In 3 cases CT showed calcified plaques not revealed on physical examination; in 2 cases the plaques revealed by palpation were not confirmed by CT. Furthermore there may be a connection between CT aspects of the albuginea and the hystological findings in the disease: irregularities could represent the early stage, interruptions the mid-stage and calcifications irreversible final abnormalities. CT, being a non-traumatic, harmless diagnostic method, improves the clinical evaluation of the patient and can facilitate the choice of the most suitable therapeutic modalities, as well as the follow-up of their results.