彩色多普勒超声结合海绵体药物注射在阴茎勃起功能障碍诊断中的应用

Application of color Doppler ultrasound combined with intracavernous injection in diagnosis of penis erectile dysfunction

目的探讨彩色多普勒超声结合海绵体药物注射（ICI）在阴茎勃起功能障碍（ED）诊断中的应用价值。方法117例ED患者阴茎海绵体内注入罂粟碱注射液30mg诱导阴茎勃起，应用超声观测注药前后海绵体动脉内径、收缩期峰值流速（PSV）、舒张末期流速（EDV）及阻力指数（RI）。结果注药后阴茎勃起正常46例（39．32％），其海绵体动脉PSV≥135cm／S，EDV〈5cm／s，RI≥1．0。血管性ED中，动脉性ED24例（20．5％），海绵体动脉PSV〈35cm／s，EDV〈5cm／s；静脉性ED30例（25．6％），海绵体动脉PSV≥35cm／s，EDV≥5cm／s；混合性ED17例（14．5％），海绵体动脉PSV〈35cm／s，EDV≥5cm／s。所有血管性ED患者RI〈1．0，注药后动脉内径无明显差异。结论彩色多普勒超声与ICI结合是诊断血管性ED一种可靠的检查方法。

Objective To explore the application value of color Doppler ultrasound combined with intraeavernous injection in diagnosis of penis erectile dysfunction （ ED ）. Methods One hundred and seventeen patients with ED were injected with 30 mg papaverine in corpus cavernosum penis to induce erectile. The diameter of corpus cavernosum artery, peak systolic velocity （PSV） , end diastolic velocity （EDV） and resistance index （RI） were examined by ultrasound before and after intracavernous injection. Results After intracavernous injection, there were 46 case （39.3%） of normal penile erection with PSV ≥ 35 cm/s, EDV 〈 5 cm/s and RI ≥ 1.0. While in vasculogenic ED, there were 24 cases （20.5%） of arteriogenic ED with PSV 〈 35 cm/s, EDV 〈5 cm/s, and 30 cases （25.6%）of venogenic ED with PSV≥35 cm/s, EDV≥5 cm/s. There were 17 cases （ 14.5% ） of mixed vascular ED with PSV 〈 35cm/s, EDV ≥5cm/s. RI of all the patients with vascular ED was less than 1.0. There was no significant difference in the diameter of artery after intracavernous injection. Conclusion Intraeavernous injection combined with color Doppler ultrasound is a reliable method in diagnosis of vascular ED.