双功能超声和阴部内动脉造影检查在外伤动脉性勃起功能障碍诊断中的应用(附7例报告)

Duplex Ultrasonography and Internal Pudendal Arteriogram in the Diagnosis of Trauma-associated Arteriogenic Erectile Dysfunction (a Report of 7 Cases)

目的探讨双功能超声(DU)、阴部内动脉造影(IPA)在外伤动脉性勃起功能障碍诊断中的应用。方法7例骨盆骨折外伤引起阴茎动脉供血受损致勃起功能障碍患者进行DU和IPA检查。结果DU检查提示7例患者阴茎勃起动脉血液灌注血流动力学受到损害。IPA检查显示7例患者有阴茎动脉血供受损解剖形态学上的变化,包括阴部内动脉断裂、阴茎动脉主干断裂、阴茎动脉主干狭窄和髂总动脉假性动脉瘤病变。结论DU和IPA为阴茎动脉功能和解剖形态学“金标准”试验,DU提供了阴茎勃起动脉血供受损血流动力学改变的客观数据,而IPA显示了阴茎动脉受损解剖形态学上的变化,对损伤病变部位进行定位。对于外伤所致动脉性勃起功能障碍的患者首选DU检查。

Objective: To make a compariative study of duplex ultrasonography (DU) and internal pudendal arteriogram (IPA) in the diagnosis of trauma-associated arteriogenic erectile dysfunction (ED). Methods: Seven patients suffering from arteriogenic erectile dysfunction caused by pelvic fracture trauma underwent comprehensive history inquiries and physical examinations by duplex ultrasonography and internal pudendal arteriogram, which ruled out neurogenic erectile dysfunction. Results: DU suggested penile artery blood flow injury, and IPA indicated artery injury in all the cases, including left internal pudendal artery injury, right or left common penile artery injury and bilateral common penile artery injury. Conclusion: Trauma-associated arteriogenic erectile dysfunction may result from common penile artery injury and internal pudendal artery injury. DU is proved valuable for evaluating hemodynamic abnormalities of cavernous artery flow, and IPA useful in locating common penile artery and internal pudendal artery injury. DU can be used as the first line diagnostic means to define trauma-associated arteriogenic ED.