Siraj Q H, Hilson A J, Bomanji J, Ahmed M
Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
Nucl Med Commun. 1993 Nov;14(11):976-82. doi: 10.1097/00006231-199311000-00007.
Dynamic penile scintigraphy was performed using 99Tcm-labelled autologous erythrocytes in five normally potent volunteers and 22 patients with erectile dysfunction including 11 patients with psychogenic and 11 patients with vasculogenic impotence (four arteriogenic, three venogenic, three arteriogenic and venogenic, one arteriogenic and neurogenic). Penile radioactivity changes in the flaccid state were monitored by a gamma camera for 60 min after injection of the radionuclide. The penile time-activity curves of the normal controls characteristically showed secondary pulses of increased activity of variable amplitude, duration and frequency, consistent with phasic increase in penile blood pool. This normal rhythmic pattern was impaired in patients with penile arterial insufficiency whereas a blunted pattern was seen in most patients with functional impotence as well as in patients with nonarteriogenic organic impotence with a psychological overlay. This study provides new insights into the flaccid penile circulatory physiology, which may contribute to our understanding of the pathophysiology of erectile dysfunction. In arteriogenic subjects, the impaired response may be attributable to an inadequacy of penile arterial inflow as well as secondarily due to the resultant sinusoidal dysfunction subsequent to penile ultrastructural damage due to an altered nutritive environment. Increased adrenergic activity in patients with psychogenic impotence may be responsible for the observed deviation from the normal pattern.
使用99锝标记的自体红细胞对5名性功能正常的志愿者和22名勃起功能障碍患者进行了动态阴茎闪烁扫描，其中包括11名心因性勃起功能障碍患者和11名血管性阳痿患者（4名动脉性、3名静脉性、3名动静脉性、1名动脉性和神经性）。注射放射性核素后，用γ相机监测阴茎在疲软状态下60分钟的放射性变化。正常对照组的阴茎时间-活性曲线特征性地显示出活动增加的继发性脉冲，其幅度、持续时间和频率各不相同，这与阴茎血池的阶段性增加一致。阴茎动脉供血不足的患者这种正常的节律模式受损，而大多数功能性阳痿患者以及伴有心理叠加因素的非动脉性器质性阳痿患者则表现为钝性模式。本研究为疲软阴茎的循环生理学提供了新的见解，这可能有助于我们理解勃起功能障碍的病理生理学。在动脉性患者中，反应受损可能归因于阴茎动脉流入不足，以及继发于营养环境改变导致阴茎超微结构损伤后的窦状隙功能障碍。心因性阳痿患者肾上腺素能活性增加可能是观察到的与正常模式偏差的原因。
