Benet A E, Rehman J, Holcomb R G, Melman A
Department of Urology, Montefiore Medical Center, Bronx, New York 10467, USA.
J Urol. 1996 Dec;156(6):1947-50.
The computer generated recordings for 2 nights in 40 patients studied with the RigiScan device were reevaluated using the new RigiScan Plus software to test its value in improving the discrimination between psychogenic and organic erectile dysfunction.
Each man was evaluated for erectile dysfunction with a detailed medical and sexual history, physical examination, biothesiometry, plethysmography, 2 nights of ambulatory RigiScan monitoring and a psychological evaluation that usually included a private interview with the sexual partner. At the conclusion of evaluation each patient was broadly classified as having organic or psychogenic erectile dysfunction. The RigiScan reports were initially independently analyzed without the investigator's knowledge of the final diagnosis by determining the single best erectile event, with a minimal cutoff value of 60% erection for 5 minutes as necessary to be considered normal and the sum of measurements from the 2 nights. The original reading and final diagnosis were correlated. At this point the data were processed with the new RigiScan Plus software using 2 new measurements: 1) rigidity activity units and 2) tumescence activity units at the base and tip of the penis, and the results were correlated with the final diagnosis.
Evaluation of the single best event again showed that tip rigidity was the best single predictor if the diagnostic criteria were modified to 70% tip rigidity for 5 minutes with an estimate of correct classification of 92.5%. Nearly the same accuracy was obtained by base single event rigidity, tip rigidity and base tumescence activity units (each 90%). The summary analysis of all erectile events during the 2 nights of evaluation that had a low correlation with the final diagnosis using the original software showed that the best overall predictor of final diagnosis was tip tumescence activity units (92.5%), followed by base rigidity and tumescence activity units (each 90%).
The RigiScan Plus software introduced 4 new parameters that facilitate interpretation of the RigiScan data. The new software did not improve the correlation with the final diagnosis compared to the subjective single best event analysis but added new objective parameters, measured and displayed by the software, that facilitate use of the data by the physician.
使用新型RigiScan Plus软件对40例使用RigiScan设备进行研究的患者两晚的计算机生成记录进行重新评估，以测试其在改善心理性和器质性勃起功能障碍鉴别诊断方面的价值。
对每名男性进行勃起功能障碍评估，包括详细的病史和性史、体格检查、生物感觉测量、体积描记法、两晚的动态RigiScan监测以及心理评估，心理评估通常包括与性伴侣的单独面谈。评估结束时，将每名患者大致分为患有器质性或心理性勃起功能障碍。RigiScan报告最初在研究者不知最终诊断结果的情况下进行独立分析，通过确定单一最佳勃起事件进行分析，勃起持续5分钟且硬度至少达到60%视为正常，同时计算两晚测量值的总和。将最初的读数与最终诊断结果进行关联。此时，使用新型RigiScan Plus软件处理数据，采用两个新的测量指标：1）阴茎根部和顶端的硬度活动单位；2）肿胀活动单位，并将结果与最终诊断结果进行关联。
对单一最佳事件的评估再次表明，如果将诊断标准修改为阴茎顶端硬度达到70%并持续5分钟，顶端硬度是最佳的单一预测指标，正确分类估计为92.5%。阴茎根部单一事件硬度、顶端硬度和根部肿胀活动单位的准确率相近（均为90%）。使用原始软件对评估两晚期间所有勃起事件进行的总结分析与最终诊断的相关性较低，结果显示最终诊断的最佳总体预测指标是顶端肿胀活动单位（92.5%），其次是根部硬度和肿胀活动单位（均为90%）。
RigiScan Plus软件引入了4个新参数，便于对RigiScan数据进行解读。与主观的单一最佳事件分析相比，新软件并未提高与最终诊断的相关性，但增加了软件测量和显示的新客观参数，便于医生使用这些数据。
