彩色多普勒超声在诊断阴茎勃起功能障碍中的应用价值

目的 评估彩色多普勒超声在诊断阴茎勃起功能障碍(erectile dysfunction,ED)中的临床应用价值.方法 应用彩色多普勒超声检测79例疑似为血管性勃起功能障碍患者,观察海绵体注射血管活性药物前后阴茎海绵体动脉血流动力学变化情况,测量并加以分析阴茎探动脉收缩期最大血流速度(PSV)、舒张末期最小流速(EDV)、海绵体动脉血流阻力指数(RI)以及阴茎背深静脉的血流状态.结果 非血管性ED 23例(29.1％),动脉性ED 35例(44.3％),静脉性ED 21例(26.6％).注射血管活性药物后非血管性ED组的收缩期峰值流速(PSV),舒张期流速(EDV)及阻力指数(RI)的数值高于动脉性ED组,差异有统计学意义(P＜0.05).结论 彩色多普勒超声技术是目前诊断血管性勃起功能障碍的一种微创而可靠地检查方法,其能够定量反应阴茎的血流动力学状态,为合理治疗勃起功能障碍提供有价值的诊断依据.

Value of color Doppler ultrasonography in Diagnosis of erectile dysfunction

Objective To investigate the value of color Doppler ultrasonograpy in the diagnosis of patients with ED who were injected with papaverin plus phentolamine intracavernously. Methods Totally 79 patients with ED were e- valuated by color Doppler ultrasonography. Diagnostic tests were undertaken after an intracavernous injection with papaverin 20 mg plus phentolamine 15 rag. The peak systolic velocity （PSV）, end diastolic velocity（EDV ）, resistive index（RI） of deep penile artery and deep dorsal vein velocity were measured and analyzed. Results There were 23 patients with nonvasculogenic ED（29.1 % ）, 35 patients with arteriogenic ED（ 44.3% ）, 21 patients with venogenic ED （ 26. 6 %0 ）. When penis was erected, the PSV, EDV, RI of nonvasculogenic ED were obviously higher than those of arteriogenic ED（P〈0.05 ）. Deep dorsal vein velocity of venogenic ED was obviously higher than those of nonvascu- logenie ED and arteriogenie ED（ P〈0.05 ）. Conclusions Color Doppler ultrasonography allows accurate location and evaluation of the hemodynamics of the cavernous artery and deep dorsal vein. It is the minimal invasive and accurate method in the diagnosis of ED.