多层螺旋CT三维血管成像在静脉性阴茎海绵体漏的应用与征象分析

Application and Analysis of Multi-slice Spiral CT Angiography in Venous Penile Cavernous Leakage

目的 建立阴茎静脉回流系统的3D-CT模型,对静脉性阴茎勃起功能障碍患者的阴茎静脉漏作出精确定位诊断。方法 收集临床诊断为阴茎勃起功能障碍的患者58例,其中阴茎海绵体造影检查25例,阴茎海绵体CT血管增强检查33例。采用MIP+VR后处理技术重建阴茎及盆腔静脉的CT三维图像。由两名具有10年以上影像学诊断经验的医师在盲法条件下对2组图像进行主观质量评价,采用t检验对两组评分比较,采用Kappa检验对图像质量一致性进行评估。结果 25例X线阴茎海绵体造影检查成功率100%,诊断阳性率88%;33例CT增强检查成功率100%,诊断阳性率100%。两名医师对CT三维重建图像质量评价一致性好(Kappa值为0.763),对造影图像质量评价一致性一般(Kappa值为0.449);CT血管增强图像质量评分为(4.44±0.68)分,造影图像质量评分为(3.52±0.91)分,两者间差异具有统计学意义(P<0.05)。结论 利用多层螺旋CT三维成像技术,完成阴茎静脉回流系统解剖性重建,并建立阴茎静脉回流系统3D-CT模型。

Objective To establish a 3D-CT model of penile venous reflux system for accurate location diagnosis of penile venous leakage in patients with venous erectile dysfunction.Methods 58 patients with penile erectile dysfunction were collected,including 25 cases of corpus cavernosum radiography and 33 cases of corpus cavernosum CT vascular enhancement.Three-dimensional images of penis and pelvic vein were reconstructed by MIP+VR post-processing technique.The subjective quality evaluation was blinded by two physicians with more than 10 years of diagnostic experience,t-test was used for two sco res and Ka ppa test for image quality consistency.Results The success x-rate of corpus cavernography in 25 cases was 100%,and the diagnostic positive rate was 88%.In 33 cases,the success rate of CT enhancement examination was 100%,and the diagnostic positive rate was100%.The consistency of image quality evaluation of CT 3D reconstruction(Kappa value=0.763) was higher than that of cont rast image(Kappa value=0.449),and the image quality sco res of the two groups were(4.44±0.68)and(3.52±0.91).There were significant differences between the image quality scores of two groups(P<0.01).Conclusion The anatomical reconstruction of penile venous return system was completed by using multi-slice spiral CT 3D imaging technology,and the 3D-CT model of penile venous return system was established.