三维CT海绵体造影与X线海绵体造影在诊断513例静脉漏性勃起功能障碍患者中的对比研究  

Three-dimensional CT cavernosography versus X-ray cavernosography in diagnosis of erectile dysfunction caused by venous leakage:a cohort study in 513 patients

作　　者：程永彪 李峻 刘倩[1] 王进 李森 张友朋 汤永 曾汉青 朱朝辉[1] 杨炼 CHENG Yongbiao;LI Jun;LIU Qian;WANG Jin;LI Sen;ZHANG Youpeng;TANG Yong;ZENG Hanqing;ZHU Zhaohui;YANG Lian(Department of Urology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China;Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology)

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022 [2]华中科技大学同济医学院附属协和医院放射科

出　　处：《临床泌尿外科杂志》2018年第8期615-619,共5页Journal of Clinical Urology

摘　　要：目的:对比三维计算机断层扫描(3D-CT)海绵体造影与传统X线海绵体造影在静脉漏性勃起功能障碍(ED)诊断中的作用。方法:采用队列研究设计,本研究纳入了2015年7月~2017年6月在我院行3D-CT海绵体造影或传统X线海绵体造影的患者。将行3D-CT海绵体造影的患者设为3D-CT组,行X线海绵体造影的患者设为X线组。记录并比较两组患者的基本资料、国际勃起功能指数(IIEF-5)评分、症状自评量表(SCL-90)评分、检查时间、造影剂量、诊断时间、不良反应、造影的静脉或结构。结果:共纳入513例患者,其中3D-CT组228例,X线组285例。3D-CT组的造影剂量、辐射剂量、检查时间均明显低于X线组(P<0.01)。6.1%的3DCT组患者以及8.4%的X线组患者未发现阴茎静脉造影。相比于X线组,3D-CT组在脚静脉、闭孔静脉、前列腺静脉丛、阴部外静脉显影率明显更高(P<0.05)。CT组患者的疼痛和包皮血肿的发生率均明显低于X线组(P<0.05)。结论:相比于X线海绵体造影,3D-CT海绵体造影的造影剂量、辐射剂量以及不良反应(疼痛和包皮血肿)发生率更低,检查时间更短,并且在脚静脉、闭孔静脉、前列腺静脉丛和阴部外静脉的显影率更高。因此,3D-CT海绵体造影是一种值得推广的诊断静脉漏性ED的方法。Objective：To assess three-dimensional CT（3 D-CT）cavernosography versus conventional X-ray cavernosography in the diagnosis of erectile dysfunction（ED）caused by venous leakage.Method：With the design of a cohort study,we included the patients who underwent 3 D-CT or X-ray cavernosography in our department of urology from July 2015 to June 2017.The patients who underwent 3 D-CT cavernosography were the study group,while those who underwent X-ray cavernosography were the control group.We collected and compared the basic information,scores of 5-item version of the International Index of Erectile Function（IIEF-5）,Global severity index（GSI）of Symptom Checklist-90（SCL-90）,testing time,contrast dose,diagnosis time,adverse reactions and contrast positions of patients between two groups.Result：We included 513 patients,with 285 patients in conventional group and 228 patients in 3 D-CT group.The contrast dose,radiation dose,and testing time of the CT group were lower than those of X-ray group（P〈0.01）.We found 6.1% of the patients in 3 D-CT group and 8.4% of the patients in X-ray group had no contrast in any penile vein.Compared with conventional X-ray cavernosography,3 D-CT cavernosography showed higher contrast rates in crural vein,obturator vein,prostatic venous plexus and external pudendal vein（P〈0.05）.Patients in CT group experienced less rates of pain and foreskin hematoma than patients in X-ray group did（P〈0.05）.Conclusion：Three-dimensional CT cavernosography needs less contrast dose,less radiation dose and less testing time,causes less rates of adverse reactions（pain and foreskin hematoma）and shows higher contrast rates in crural vein,obturator vein,prostatic venous plexus and external pudendal vein than X-ray cavernosography does.Thus,3 D-CT cavernosography is a promising tool in diagnosis of ED caused by venous leakage.

关 键 词：勃起功能障碍 海绵体造影 诊断 

分 类 号：R698.1[医药卫生—泌尿科学]