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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 evaluate the value of 320-slice CT in the diagnosis of venous erectile dysfunction (ED) by using Toshiba 320 dynamic volume CT dynamic imaging technique. Methods: Outpatient audio-visual stimuli detector screening for ED patients 33 cases, penicillin local injection of phentolamine 2 mg + papaverine 30 mg induced erection, successively from the venous, penile cavernous injection of iodine alcohol were 320 Row CT dynamic volume scanning acquisition dynamic and venous penile cavernous images and image post-processing. Results: Twenty-nine of 33 patients had abnormal drainage veins with different degrees. The venous leaks were found in 7 cases (24.1%) with dorsal deep venous drainage, 6 cases (20.7%) with venous leakage and 3 cases with dorsal superficial venous leakage (10.3%), 1 case of interventricular septum leakage (3.5%), 2 cases of cavernous venous leakage (6.9%) and 10 cases of mixed venous leakage (34.5%). Surgical treatment was performed in 10 patients. 2 cases were ligated with dorsal penile vein, 4 cases were ligated with dorsal penile vein and 4 cases were ligated with foot vein. 8 cases were followed up for 3 to 12 months, 2 cases of erectile improvement, 6 cases of erectile function returned to normal. Conclusions: The 320-row dynamic volume CT dynamic imaging is a reliable method to diagnose venous ED, which can accurately show the site of venous drainage and guide the clinical treatment. Compared with penile cavernous angiography, there are clearer diagnostic images, less radiation dose and Contrast dose, shorter examination time.