Povelitsa E, Dosta N I, Parhomenko O V, Nitkin D M, Shesternja A M, Anichkin V V
Republican Scientific Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
Urologiia. 2017 Sep(4):55-61.
To determine the practical and diagnostic value of transperineal ultrasound imaging of the internal pudendal artery (IPA) in patients with arteriogenic erectile dysfunction (ED).
Transperineal IPA and penile Doppler ultrasonography was performed in 50 healthy young male volunteers aged 23.6+/-3.4 years without ED (IIEF-5 score of 21-22) and 60 patients with ED (IIEF-5 score of 6-18, mean age 49+/-4.6 years), including 30 men with prostate cancer (PCa) after comprehensive treatment and 30 patients with type 1 and type 2 diabetes mellitus. To determine the diagnostic value of the transperineal IPA imaging, the results were compared with the findings of magnetic resonance or contrast-enhanced dynamic CT angiography of the iliac arteries.
In all healthy men no abnormalities were found in the perineal primary arterial blood flow, in 100% of cases perineal branch of IPA was rectilinear, while patients with arteriogenic ED had low IPA and penile peak systolic blood flow velocity (<0.05), pathologically altered type of blood flow and non-rectilinear course of IPA, stenosis and occlusion in the pelvic and extrapelvic branches of IPA. When comparing the findings of IPA Doppler ultrasound and angiography studies of the small pelvis in healthy men, they completely matched, showing satisfactory arterial IPA perfusion, absence of stenoses or occlusions. Sensitivity and specificity of the transperineal IPA ultrasound imaging were 95% and 90%, respectively.
Transperineal IPA ultrasound imaging allows to assess the important morphometric features of the perineal branches of IPA - the arterial diameter, the response to stimulation, the course of the artery, the type of arterial blood flow, the presence or absence of arterial stenoses and occlusions, and to measure peak systolic blood flow velocity.
确定经会阴超声成像评估阴部内动脉（IPA）对动脉源性勃起功能障碍（ED）患者的实际应用价值及诊断价值。
对50名年龄在23.6±3.4岁、无勃起功能障碍（国际勃起功能指数-5评分21 - 22分）的健康年轻男性志愿者以及60名勃起功能障碍患者（国际勃起功能指数-5评分6 - 18分，平均年龄49±4.6岁）进行经会阴IPA及阴茎多普勒超声检查，其中包括30名综合治疗后的前列腺癌（PCa）男性患者和30名1型及2型糖尿病患者。为确定经会阴IPA成像的诊断价值，将结果与髂动脉磁共振成像或对比增强动态CT血管造影的结果进行比较。
所有健康男性会阴部主要动脉血流均无异常，100%的病例中IPA会阴支呈直线状，而动脉源性ED患者的IPA及阴茎收缩期峰值血流速度较低（<0.05），血流类型发生病理改变，IPA走行非直线状，IPA盆腔及盆腔外分支存在狭窄和闭塞。在比较健康男性IPA多普勒超声与小骨盆血管造影研究结果时，二者完全匹配，显示IPA动脉灌注良好，无狭窄或闭塞。经会阴IPA超声成像的敏感性和特异性分别为95%和90%。
经会阴IPA超声成像能够评估IPA会阴支的重要形态学特征，包括动脉直径、对刺激的反应、动脉走行、动脉血流类型、有无动脉狭窄和闭塞，并可测量收缩期峰值血流速度。
