Nessi R, De Flaviis L, Bellinzoni G, Freri F, Salvini A
Department of Radiology, University of Milan, Italy.
Br J Urol. 1987 Jun;59(6):584-9. doi: 10.1111/j.1464-410x.1987.tb04882.x.
Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus. In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno-occlusive lesions of different degrees of severity. The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive. In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.
对44例疑似血管源性勃起功能障碍的患者进行了阴部和阴茎动脉的数字血管造影。6例患者通过对腹下动脉进行选择性插管经动脉内注射造影剂。在39例患者中，其中1例已经进行过动脉插管，通过静脉途径给予造影剂，采用单次大剂量、高速推注。在44例中的12例（27%）中，数字血管造影显示阴部和阴茎水平的血管图像正常，但其余32例患者（73%）有不同严重程度的狭窄闭塞性病变。静脉注射造影剂后获得的图像在诊断上与选择性动脉插管研究一样好。此外，静脉途径可以同时显示双侧动脉网络，且更快、侵入性更小。在44例患者中的31例（79%）中，进行了夜间阴茎勃起功能和阴茎血流的功能测定以作比较。夜间阴茎勃起结果与血管造影图像相关性良好。用多普勒技术测量阴茎血流比数字血管造影敏感性低。
