320排动态容积CT阴茎海绵体造影诊断静脉性ED的应用价值

Application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction

目的：通过Toshiba320排动态容积CT动态成像技术,探讨320排CT对诊断静脉性勃起功能障碍（ED）的应用价值。方法：门诊视听刺激检测仪筛查诊断为ED患者33例,阴茎海绵体局部注射酚妥拉明2 mg＋罂粟碱30 mg诱发勃起后,先后从静脉、阴茎海绵体注入碘比醇,分别作320排CT动态容积扫描采集动、静脉期阴茎海绵体图像,并进行图像后处理。结果：33例患者中29例有不同程度的异常引流静脉,所显示的静脉漏分为背深静脉漏7例（24.1%）、脚静脉漏6例（20.7%）、背浅静脉漏3例（10.3%）、间静脉漏1例（3.5%）、海绵体静脉漏2例（6.9%）、混合静脉漏10例（34.5%）。10例患者选择手术治疗,行阴茎背深静脉结扎2例、阴茎背深静脉包埋＋脚静脉结扎4例、阴茎脚静脉结扎4例。术后8例获3~12个月随访,2例勃起改善,6例勃起功能基本恢复正常。结论：320排动态容积CT动态造影是诊断静脉性ED的可靠方法,可准确显示静脉漏的部位,指导临床治疗;相比于阴茎海绵体造影有更清晰的诊断图像、更少的放射剂量及对比剂量、更短的检查时间。

Objective： To investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diag- nosis of venous erectile dysfunction （VED）. Methods ： We enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed. Results ： Different degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases （24.1%） of back deep venous leakage, 6 cases （20.7%） of foot venous leakage, 3 cases （ 10.3% ） of dorsal superficial venous leakage, 1 case （3.5%） of intervertebral venous leakage, 2 cases （6.9%） of cavernous venous leakage, and 10 cases （34.5%） of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for3 - 12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection. Conclusion： Toshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radia- tion, and faster examination than X-ray penile angiography.