Helweg G
Univ. Klinik für Innere Medizin, Universität Innsbruck, Osterreich.
Urologe A. 1992 Jan;31(1):19-23.
The diagnosis of penile induration (Peyronie's disease; IPP) requires an appropriate history, clinical examination, autophotography and plain films in cases of calcified plaques, but ultrasound is the modality of choice. Besides the benefit of an exact staging (Kelâmi method) high-frequency ultrasound probes offer the possibility of detecting nonpalpable plaques early detection of changes in the tunica albuginea. Evaluation of inflammatory changes and disappearance of hyperechoic signs around the plaques or an increasing density of the corresponding corpus cavernosum can be detected by ultrasound, but sometimes to a restricted extent. In selected cases MRI offers the additional benefit of early detection of inflammatory changes of the dependent corpus cavernosum. Our own experience in the diagnosis of Peyronie's disease by ultrasound and MRI in cases of inflammatory changes are presented, especially after administration of Gd-DTPA. For hemodynamic disorders causing erectile dysfunction, in 50% of cases with IPP combined, pharmacocavernosometry and pharmaco-cavernosography are of considerable value. The use of modern diagnostic imaging modalities, e.g. ultrasound and especially MRI, increases the diagnostic impact in cases of IPP.
阴茎硬结症(佩罗尼氏病;阴茎海绵体硬结症)的诊断需要详细的病史、临床检查、自体摄影以及对于钙化斑块病例的平片检查,但超声是首选的检查方式。除了能够进行精确分期(凯拉米方法)之外,高频超声探头还能够检测到无法触及的斑块,并早期发现白膜的变化。超声可以评估炎症变化以及斑块周围高回声体征的消失情况,或者相应海绵体密度的增加,但有时程度有限。在特定病例中,MRI具有额外的优势,能够早期发现附属海绵体的炎症变化。本文介绍了我们自身通过超声和MRI诊断佩罗尼氏病炎症变化病例的经验,特别是在注射钆喷酸葡胺之后。对于导致勃起功能障碍的血流动力学紊乱,在50%合并阴茎硬结症的病例中,药物海绵体测压和药物海绵体造影具有重要价值。使用现代诊断成像方式,如超声尤其是MRI,能够提高阴茎硬结症病例的诊断效果。