The Value Of Gemstone CT Corpus Cavernosum And Three-dimensional Reconstruction In The Diagnosis And Treatment Of Venous Erectile Dysfunction

BackgroundPenile cavernous angiography under gemstone CT is a new exploration method for the diagnosis and adjuvant treatment of Venous erectile dysfunction(VED).At present,the main diagnostic methods of VED include color doppler duplex ultrasound(CDDU)and cavernous angiography of the penis.In clinical work,CT-assisted penile cavernous angiography has begun to be used.Not only the image is clear,but also the three-dimensional reconstruction has a good three-dimensional sense.It can clearly distinguish the diseased blood vessel distribution and venous leakage in VED patients.The medical history can be used to grade patients and choose different treatment methods,which has good clinical value.ObjectiveThis study explored the value of gemstone CT penile cavernous angiography and three-dimensional reconstruction in the diagnosis and treatment of venous erectile dysfunction,and preliminary observation of its role in the clinic,in order to provide new ideas for the diagnosis and treatment of venous erectile dysfunction.MethodsRetrospective analysis of patients with erectile dysfunction admitted to the andrology and outpatient departments of the Department of Andrology and Energy Medicine of Henan Provincial People's Hospital from April 2017 to April 2019,after medical historyassessment,psychological evaluation,penile evoked potential examination,RIGSACN,CDDU,serum hormones Level test examination suspected VED patients,combined with inclusion criteria and exclusion criteria,a total of 248 cases met the conditions.The patients were divided into two groups,one group underwent traditional radiographic X-ray cavernography,122 patients were set as X-ray group,and the other group underwent gemstone CT penile cavernography,with 126 patients set as CT group.The general information of the two groups of patients,the international erectile function index-erectile function domain(IIEF-EF)score,erectile stiffness assessment(EHS),operating time,contrast agent dose,and adverse reactions were compared.Inclusion criteria: 1.Before CT and X-ray imaging and interventional therapy,fully communicate the patient's condition and possible complications and obtain the patient's own consent.2.Have a history of more than 6 months of erectile dysfunction,and have a stable sexual partner.3.The compliance of the treatment is good,and the follow-up follow-up can be completed on time.4.Oral drugs are ineffective,IIEF-5 score 5-11 points,average 8 points,NPT continuous monitoring for 3 nights,no obvious erection reaction.Exclusion criteria: 1.Medical history and psychological evaluation,excluding patients with anxiety,depression,and mental illness;2.Low serum testosterone levels,suggesting endocrine ED;3.Abnormal penile evoked nerve potential test,suggesting neurological ED;4.CDDU examination of cavernous artery diameter <0.7mm,PSV <25cm / s,suggesting arterial ED.Patients who underwent corpus cavernosography under gemstone CT combined with three-dimensional reconstruction images to evaluate the severity of venous leakage of the corpus cavernosum,and observed whether there was a corresponding relationship with its IIEF-5 score.ResultsThe CT and X-ray images of penile cavernous corpuscles showed that there were 105 and 97 patients with different degrees of penile cavernous venous leakage,respectively.It can be seen that the number of patients with CT leakage in CT group is significantly higher than that in X-ray group For the penile vein CT group with deep anatomical position orinterference with pelvic tissue,the imaging and visualization ratio was higher than that of the X-ray group.In both groups,the CT time,contrast agent dose,and adverse reactions were superior to the X-ray group(P <0.05).According to the results of corpus cavernosum imaging under gem CT,patients with venous leakage of penile corpus cavernosum were divided into mild,moderate and severe,and the average values of IIEF-5 score were 17.15,9.58 and 4.52,respectively.ConclusionGem CT penile cavernous angiography can clearly show the area and scope of penile cavernous venous leakage,which can provide anatomic basis for the diagnosis of venous ED,and can also provide important help for the choice of intravenous ED treatment.For the diagnosis of VED patients through CT angiography,it plays an important role in the choice of treatment options,and for patients with severe penile cavernous venous leakage and poor conservative treatment,combined interventional embolization can be a safe and effective method But still need to expand the sample and prolong the follow-up time to observe the effect.Overall,cavernous angiography of the penis with gemstone CT plays a key grading role in the diagnosis of patients with erectile dysfunction and can be used as a reference for interventional embolization with less trauma.However,the diagnostic value of CT angiography needs larger sample sizes and controlled studies to further evaluate.