^(99m)Tc标记物阴茎海绵体动态显像对血管性阳萎的评价

A study on the methodology of penile cavernous dynamic imaging for evaluating vasculogenie impotence using ^(99m)Tc

为建立阴茎动、静脉系统动态显像定量分析方法,采用^(99m)Tc 标记 RBC 和植酸钙胶体(PHY)研究了6例正常男子和24例阳萎病人阴茎海绵体血液动力学变化,并在盐酸罂粟碱负荷下连续测量阴茎海绵体内放射性变化。通过测量肝脏和外周血中^(99m)Tc-PHY 放射性,计算其再循环量。结果:6例正常男子阴茎动脉系统显像指数(PIA)为0.90±0.38,注入盐酸罂粟碱后达曲线1/2高峰值的时间(1/2PT)为1.84±0.50分钟,阴茎静脉系统显像指数(PIV)为-0.21±0.06。根据正常值 PIA>0.60,PIV>-0.45,将24例阳萎病人分为4组,其中 PIA、PIV 正常的为非血管性阳萎组;PIA 正常、PIV异常的为静脉性阳萎组;PIA 异常、PIV 正常的为动脉性阳萎组;PIA、PIV 均异常的为动静脉性阳萎组。阴茎再循环量计数对 PIV 影响的绝对值小于0.04。因此^(99m)Tc-PHY 可以代替^(133)Xe 用于阴茎静脉系统动态显像。阴茎海绵体动态显像是评价血管性阳萎的一种安全、无创、客观和准确的方法。

PURPOSE To develop a new quantitative diagnosis method for vasculogenic impotence.METHODS The penile cavernous hemodynamic changes of 6 normal volunteers and 24 impotent patients were studied using ^(99m)Tc-RBC 370MBq and ^(99m)Tc- PHY 37MBq.The arterial and venous penile images were evaluated with intravenous and intracavemous administration of ^(99m)Tc and al- so monitored both before and after intracavernous papaverine injection.The recirculation of ^(99m)Tc-PHY were calculated by measur- ing the counts of liver tissue and venous blood.RESULTS The penogram index of arterial system (PIA) of 6 volunteers was 0.90±0.38,1/2peak time was 1.84±0.50min,and the penogram index of venous system (PIV) was-0.21±0.06.PIA> 0.60 and PIV>-0.45 were accepted as normal.According to this normal value 24 impotent patients were classified into 4 groups:4 with psychogenic impotence (PIA 0.72±0.16,PIV-0.32±0.08);9 with venogenic impotence(PIA 0.86±0.25, PIV-0.75±0.13);5 with the arteriogenic impotence (PIA 0.28±0.09,PIV-0.29±0.21);6 with both arteriogenic and venogenic impotence (PIA 0.28±0.17,PIV-0.75±0.12).The cavernous of ^(99m)Tc-PHY value due to recirculation is very low,and is less than 0.01.CONCLUSIONS The radioisotope erection penogram is a safe,noninvasive and valuable screening test in the identification of vasculogenic impotence,and is effective in differentiating arteriogenic and venogenic impotence.