Lee Joo Yong, Jung Dae Chul, Lee Seungsoo, Kang Nam Gyu, Oh Young Taik, Han Kyunghwa
Department of Urology, Yonsei Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Yonsei Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
World J Mens Health. 2021 Jan;39(1):123-130. doi: 10.5534/wjmh.190094. Epub 2020 Jan 9.
To perform real-time quantitative measurements of penile rigidity for patients with erectile dysfunction (ED) using shear-wave elastography (SWE).
A total of 92 patients with clinically diagnosed ED filled out an abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire and underwent SWE as well as penile color Doppler ultrasound (CDUS) after intracavernosal injection for penile erection. Elasticity measurements were repeated on two sites of the corpus cavernosum (central and peripheral elasticity of corpus cavernosum [ECC]) and the glans penis during the erection phase. Correlations between penile elasticity and rigidity scores or IIEF-5 were evaluated statistically. Penile elasticity was also compared with the ED types based on CDUS.
The mean age of all patients was 53.5±13.4 years, and the mean IIEF-5 score was 9.78±5.01. The rigidity score and central ECC value demonstrated a significant correlation (r=-0.272; 95% confidence interval: -0.464 to -0.056; p=0.015). The IIEF-5 score was not significantly correlated with penile elasticity. Vascular ED patients showed significantly higher central ECC values than nonvascular ED patients (p<0.001). At a cut-off value of 8.05 kPa, the central ECC had a specificity of 41.5%, a sensitivity of 84.6%, and an area under the ROC curve of 0.720 with a standard error of 0.059 (p=0.019) for predicting vascular ED.
Quantitatively measuring Young's modulus of the corpus cavernosum using SWE could be an objective technique for assessing penile erectile rigidity and the vascular subtype in patients with ED.
使用剪切波弹性成像（SWE）对勃起功能障碍（ED）患者的阴茎硬度进行实时定量测量。
92例临床诊断为ED的患者填写了国际勃起功能指数（IIEF-5）问卷的简化五项版本，并在阴茎海绵体内注射药物诱发阴茎勃起后接受了SWE以及阴茎彩色多普勒超声（CDUS）检查。在勃起阶段，在阴茎海绵体的两个部位（阴茎海绵体中央和外周弹性[ECC]）以及阴茎头重复进行弹性测量。对阴茎弹性与硬度评分或IIEF-5之间的相关性进行统计学评估。还根据CDUS将阴茎弹性与ED类型进行比较。
所有患者的平均年龄为53.5±13.4岁，平均IIEF-5评分为9.78±5.01。硬度评分与中央ECC值呈显著相关性（r=-0.272；95%置信区间：-0.464至-0.056；p=0.015）。IIEF-5评分与阴茎弹性无显著相关性。血管性ED患者的中央ECC值显著高于非血管性ED患者（p<0.001）。在截断值为8.05 kPa时，中央ECC预测血管性ED的特异性为41.5%，敏感性为84.6%，ROC曲线下面积为0.720，标准误为0.059（p=0.019）。
使用SWE定量测量阴茎海绵体的杨氏模量可能是评估ED患者阴茎勃起硬度和血管亚型的一种客观技术。
