宝石CT阴茎海绵体造影及三维重建在静脉性勃起功能障碍中的诊疗价值  

The value of gemstone CT corpus cavernosum and three-dimensional reconstruction in the diagnosis and treatment of venous erectile dysfunction

作　　者：向朝杰 陈鑫 张士龙 朱晓博 陈国晓 刘利杰 郭一璞 张祥生 Xiang Chaojie;Chen xin;Zhang Shilong;Zhu Xiaobo;Chen Guoxiao;Liu Lijie;Guo Yipu;Zhang Xiangsheng(Graduate School of Xinxiang Medical University,Xinxiang,Henan 453000,China;Henan Provincial People's Hospital,Department ofAndrology and Energy Medicine Zhengzhou)

机构地区：[1]新乡医学院河南省人民医院 [2]河南省人民医院男科与能量医学科

出　　处：《中国男科学杂志》2019年第4期25-28,共4页Chinese Journal of Andrology

基　　金：河南省自然科学基金项目(编号:162300410309)

摘　　要：目的探讨宝石CT阴茎海绵体造影在静脉性勃起功能障碍中的诊疗价值。方法通过阴茎彩色多普勒(CDDU)初步检査怀疑静脉性勃起功能障碍的126例患者,行CT下阴茎海绵体造影明确是否为静脉性ED,评估阴茎海绵体静脉漏的位置及范围。结果通过CT阴茎海绵体造影图像显示:105例患者均有不同程度的阴茎海绵体静脉漏,根据每个患者不同的静脉漏类型,制定个性化治疗方案,82例采取保守治疗患者,治疗前和治疗后1-6个月随访勃起硬度均有不同程度提升。23例保守治疗无效患者采取手术治疗,10例行阴茎海绵体静脉漏介入栓塞术,13例阴茎背深静脉结扎术。术后3个月随访,行阴茎海绵体静脉漏介入栓塞术10例患者,7例患者阴茎勃起充分,2例勃起硬度稍差,1例治疗无效。13例行阴茎背深静脉结扎术患者,8例勃起硬度较前有明显改善,5例勃起硬度无明显改变。结论宝石CT阴茎海绵体造影可更清楚的显示阴茎海绵体静脉漏病变区域及范围,既能为静脉性ED的诊断提供提供解剖学依据,还可以对静脉行ED治疗方式选择提供重要的帮助作用。Objective To investigate the value of gemstone CT corpus cavemosum in the diagnosis and treatment venous erectile dysfunction. Methods A total of 126 patients with suspected organic erectile dysfunction were examined by CDDU for diagnosis of venous ED. The location and extent of corpus cavemosum venous leaks were assessed. Results CT images of the corpus cavemosum showed that 105 patients had different degrees of corpus cavemosum venous leakage. According to the different types of venous leaks of the patient, a personalized treatment plan was developed. Eighty-two patients were treated conservatively. The erection hardness was increased to varying degrees from 1-6 months after treatment. Twenty-three patients with conservative treatment were then treated with surgery, 10 patients underwent embolization of the corpus cavemosum and 13 patients underwent deep penile vein ligation. Three months after the operation, 10 patients underwent embolization of the cavernous cavernous venous leak. Seven patients had adequate penile erection, two patients had a slightly worse erection hardness, and one patient was ineffective. In 13 patients with deep penile vein ligation, the erectile stiffnesss was significantly improved in 8 cases, and there was no significant change in erection hardness in 5 cases. Conclusion Gemstone CT corpus cavemosum can more clearly show the area and extent of corpus cavemosum leakage, which can provide anatomical basis for the diagnosis of venous ED, and can also provide important help for the choice of ED treatment.

关 键 词：勃起功能障碍 静脉漏 阴茎海绵体造影 宝石CT 介入栓塞 

分 类 号：R698.1[医药卫生—泌尿科学]