Zhang Yuyang, Zhou Wang, Wu Xu, Zhao Sheng, Zhang Xiansheng
The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China.
The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Anhui province, China.
Andrologia. 2021 May;53(4):e13996. doi: 10.1111/and.13996. Epub 2021 Feb 1.
The gold-standard method for diagnosing arteriogenic erectile dysfunction (AED) is the penile Doppler ultrasonography. We proposed a novel method for predicting AED using ultrasonic shear wave elastography (SWE) considering that the former was invasive and variable. A total of 98 male patients were enrolled in our study, referred for ED between December 2018 and October 2020. For comparison, we also included 42 volunteers from the Healthy Physical Examination Center of our hospital. The Penile Doppler Ultrasonography (PDU) and SWE were performed for all patients with the intracavernosal injection (ICI). We named three groups as AED group, nonvascular ED group and healthy controls group. No statistically significant differences were found among the three groups in terms of demographic and clinical characteristics. There were no significant differences in IIEF-5 between AED and nonvascular ED. A significant (r = 0.642, p < 0.0001) positive correlation between flaccid and erectile SWE was observed. With a cut-off value of 13.45 KPa, the area under curve, specificity, and sensitivity of the SWE values under the flaccid state in distinguishing AED from healthy subjects were 0.867, 0.786 and 0.896 respectively. The SWE value in the flaccid state can distinguish the AED from healthy subjects.
诊断动脉性勃起功能障碍（AED）的金标准方法是阴茎多普勒超声检查。考虑到前者具有侵入性且存在变异性，我们提出了一种使用超声剪切波弹性成像（SWE）预测AED的新方法。共有98名男性患者纳入我们的研究，他们于2018年12月至2020年10月因勃起功能障碍前来就诊。为作比较，我们还纳入了我院健康体检中心的42名志愿者。对所有患者均进行阴茎多普勒超声检查（PDU）和SWE检查，并进行海绵体内注射（ICI）。我们将三组分别命名为AED组、非血管性勃起功能障碍组和健康对照组。三组在人口统计学和临床特征方面未发现统计学显著差异。AED组和非血管性勃起功能障碍组在国际勃起功能指数-5（IIEF-5）方面无显著差异。观察到疲软状态和勃起状态下的SWE之间存在显著正相关（r = 0.642，p < 0.0001）。以13.45千帕为临界值，疲软状态下SWE值在区分AED与健康受试者时的曲线下面积、特异性和敏感性分别为0.867、0.786和0.896。疲软状态下的SWE值可区分AED与健康受试者。
