剪切波弹性成像评价口服药物后血管性阴茎勃起障碍  

Shear Wave Elastography Used To Evaluate Vascular Penile Erectile Dysfunction After Oral Administration of Drugs

作　　者：杨方[1] 车颖[1] 邓之萌 谢文龙 Yang Fang;Che Ying;Deng Zhimeng;Xie wenlong(Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011 , China)

机构地区：[1]大连医科大学附属第一医院超声科

出　　处：《中国超声医学杂志》2019年第8期735-738,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过观测阴茎勃起功能障碍(ED)患者勃起前后的SWE弹性杨氏模量最大值(SWS-Max)及平均值(SWS-Mean)的变化规律,探讨剪切波弹性成像评估血管性ED的临床价值。方法选取因ED就诊的患者60例;根据ICI联合CDU将患者分为可纳入研究的非血管性ED (A组)、动脉性ED (B组)及静脉性ED (C组),另选取健康志愿者20例作为对照组(D组)。采取双盲法对受试者的两侧阴茎海绵体中段最大纵切面行SWE检查,获取满意图像后选取直径约3mm的圆形感兴趣区域定量测量SWS (单位kPa),每侧测量3次并记录数据,后嘱患者口服枸橼酸西地那非50mg并于1h后给予其视听刺激,在阴茎充分勃起时和勃起后13~15min时重复上述测量步骤并取平均值。结果(1)四组人群阴茎勃起时与疲软时的SWS-Max及SWS-Mean差异均具有统计学意义(P<0.001)。(2)动脉性ED与非血管性ED、健康对照组之间,疲软时SWS-Mean (P=0.872、0.165)和SWS-Max (P=0.55、0.488)均无统计学差异,勃起时及勃起后13~15min测量SWS-Mean和SWS-Max均具有统计学差异(P值均为0)。勃起时SWS-Mean最具有诊断意义。静脉性ED与非血管性ED、健康对照组之间,疲软时SWS-Max (P=0.005、0.001)及SWS-Mean (P=0.010、0.005)差异具有统计学意义,两组勃起时其数值均无统计学意义(Pmin=0.682、0.605;Pmax=0.772、0.377);静脉性ED组在勃起后13~15min的SWS-Max与SWS-Mean差异有统计学意义(P值均为0)。勃起后13~15min的SWS-Mean最具有诊断价值。(3)非血管性ED与健康对照组各状态下的SWS-Max与SWS-Mean差异均无统计学意义(Pmax分别为0.510、0.912和0.290;Pmean分别为0.547、0.916和0.394)。结论 SWE可作为血管性ED的重要辅助诊断指标。Objective To investigate the clinical value of shear wave elastography in the evaluation of vascular penile erectile dysfunction by observing the changes of the maximum and average values of SWE elastic young′s modulus and young′s modulus before and after penile erectile.Methods Sixty patients with penile erectile dysfunction admitted to our hospital from were selected.Patients were divided into non-vascular ED(Group A),arterial ED(Group B)and venous ED(Group C)that could be included in the study according to the diagnosis technology of vasoactive drug penile cavernous injection combined with color doppler ultrasound,and 20 healthy volunteers were selected as the control Group(Group D).Double-blind method was used to conduct SWE examination on the maximum longitudinal section of the middle segment of the penile cavernosum on both sides of the subject.After obtaining satisfactory images,a circular region of interest with a diameter of about 3 mm was selected for quantitative measurement of SWS(unit kPa),and each side was measured 3 times and data were recorded.After 50 mg of sildenafil citrate was taken orally by the patient,audio-visual stimulation was given to the patient 1 hour later,and the above measurement steps were repeated and averaged when the penis was fully erect and 13-15 minutes after erection.Results(1)The differences of SWS-Max and SWS-Mean between the four groups when penile erection and weakness were statistically significant(P<0.001).(2)There was no statistically significant difference in SWS-Mean(P=0.872,0.165)and SWS-Max(P=0.55,0.488)between arterial ED and non-vascular ED and healthy control group when the penis was weak.There were statistically significant differences in SWS-Mean and SWS-Max at the time of penile erection and 13-15 minutes after erection(P<0.001).SWS-Mean is of the most diagnostic significance when penile erection occurs.The difference of SWS-Max(P=0.005,0.001)and SWS-Mean(P=0.010,0.005)in penile weakness between the venous ED group and the non-vascular ED group and the

关 键 词：阴茎海绵体 勃起功能障碍 剪切波弹性成像 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R698[医药卫生—诊断学]