双核素阴茎海绵体动态显像对血管性阳萎的评价

Dual radionuclide penogram for evaluating vascular impotence

目的建立双核素阴茎海绵体动态显像的定量分析方法，用于评价血管性阳萎。方法用９９ｍＴｃＲＢＣ作阴茎海绵体动脉系统显像，１３１Ｉ邻碘马尿酸（ＯＩＨ）作阴茎海绵体静脉系统显像，并在盐酸罂粟碱负荷下连续测阴茎海绵体内放射性变化。观察１２例正常男子和４２例阳萎病人阴茎海绵体血液动力学变化。结果１２例正常男子９９ｍＴｃ阴茎动脉系统显像指数（ＴＰＩＡ）为２０７±０８４（正常值＞０６０）；１３１Ｉ阴茎静脉系统显像指数（ＩＰＩＶ）为－０３４±０１２（正常值＞－０４８）。根据ＴＰＩＡ和ＩＰＩＶ的结果，４２例阳萎病人被分为３组：１３例ＴＰＩＡ、ＩＰＩＶ正常者为非血管性阳萎组，其ＴＰＩＡ为１９０±０６９，ＩＰＩＶ为－０３６±００８；２１例ＴＰＩＡ正常、ＩＰＩＶ异常者为静脉性阳萎组，ＴＰＩＡ为１９８±０１０，ＩＰＩＶ为－０６７±０１２；８例ＴＰＩＡ异常、ＩＰＩＶ正常或异常者，其ＴＰＩＡ为０３４±０２１，ＩＰＩＶ为－０５５±０１１。结论双核素阴茎海绵体动态显像对评价血管性阳萎，特别是鉴别静脉和动脉系统方面的病理状况是一种安全、无创。

Purpose To set up a quantitative analysis method of dual radionuclide penogram for evaluating vascular impotence. Methods 42 impotent patients and 12 volunteers with normal function were studied by penile cavernous arterial system dynamic imaging using 99m Tc RBC, and venous system dynamic imaging using 131 I OIH. These techniques are based on the simultaneous recording of penile cavernous hemodynamic changes for 30min from the flaccid to full erect states by injecting 60mg papaverine into the corpus cavernousum. Results [WT5”BZ]On the basis of normal value in the 12 volunteers, the TPIA was 2 07±0 84, the IPIV was -0 34±0 12. TPIA>0 60 and IPIV>-0 48 were considered as normal. 42 impotent patients were divided into three groups: 13 of psychogenic (TPIA 1 90±0 69, IPIV -0 36±0 08), 21 of the venogenic (TPIA 1 98±0 10, IPIV -0 67±0 12), 8 of TPIA abnormal and IPIV normal or abnormal (TPIA 0 34±0 21, IPIV -0 55±0 11). Conclusion [WT5”BZ]The radionuclide erection penogram is a safe, non invasive and valuable screening test for the vasculogenic impotence, especially for the identification of arterial and venous dystunction.