Fürst G, Müller-Mattheis V, Cohnen M, Trautner C, Haastert B, Saleh A, Malms J, Ackermann R, Mödder U
Institute of Diagnostic Radiology, Heinrich Heine University, P. O. Box 101007, D-40001 Düsseldorf, Germany.
Eur Radiol. 1999;9(1):35-41. doi: 10.1007/s003300050623.
The purpose of this study was to assess the accuracy of multi-parameter measurements with color-coded duplex sonography (CCDS) for the diagnosis of venous leakage in patients with erectile dysfunction. Sixty patients with repeated unsatisfactory reactions after intracavernous injection of vasoactive substances underwent CCDS. Following intracavernous injection of prostaglandin E1, peak systolic velocity (PSV), enddiastolic velocity (EDV), time averaged velocity (TAV), resistance index (RI), and pulsatility index (PI) were measured in the cavernous arteries over 30 min (one measurement per minute). The results were compared with independent measurements based on dynamic pharmaco-cavernosometry/cavernosography (DPCC). Dynamic pharmaco-cavernosometry/cavernosography revealed venous leakage in 33 patients. Of 48 patients with normal PSV ( > 25 cm/s), 25 had veno-occlusive dysfunction and the remainder presented normal venous function. No statistically significant differences between these groups were found in EDV, RI, and PI measurements. In contrast, differences in TAV were significant between patients with (mean 9.4 +/- 4.6 cm/s) and without venous leakage (mean 5.5 +/- 2.2 cm/s; p = 0.001). Analysis of relative frequencies revealed a broad overlap of EDV, TAV, RI, and PI measurements between both groups. Sensitivities and specificities determined from receiver-operating-characteristic curves were > 80 % and > 50% for a TAV threshold of 5 cm/s, and an RI threshold of 1.0. Measurements of EDV, TAV, RI, and PI in patients with repeated unsatisfactory reactions on intracavernous prostaglandin injection are poor predictors of venous leakage and should not replace DPCC in the investigation of vasculogenic impotence.
本研究的目的是评估彩色编码双功能超声检查（CCDS）多参数测量对勃起功能障碍患者静脉漏诊断的准确性。60例海绵体内注射血管活性物质后反复出现不满意反应的患者接受了CCDS检查。在海绵体内注射前列腺素E1后，于30分钟内（每分钟测量1次）测量海绵体动脉的收缩期峰值流速（PSV）、舒张末期流速（EDV）、时间平均流速（TAV）、阻力指数（RI）和搏动指数（PI）。将结果与基于动态药物海绵体测压/海绵体造影（DPCC）的独立测量结果进行比较。动态药物海绵体测压/海绵体造影显示33例患者存在静脉漏。在48例PSV正常（>25 cm/s）的患者中，25例存在静脉闭塞功能障碍，其余患者静脉功能正常。这些组之间在EDV、RI和PI测量方面未发现统计学上的显著差异。相比之下，有静脉漏患者（平均9.4±4.6 cm/s）和无静脉漏患者（平均5.5±2.2 cm/s；p = 0.001）的TAV差异显著。相对频率分析显示两组之间EDV、TAV、RI和PI测量值有广泛重叠。对于TAV阈值为5 cm/s和RI阈值为1.0，从受试者工作特征曲线确定的敏感度和特异度分别>80%和>50%。海绵体内注射前列腺素后反复出现不满意反应的患者，其EDV、TAV、RI和PI测量对静脉漏的预测价值较差，在血管性阳痿的检查中不应取代DPCC。
