Application Of Virtual Touch Tissue Imaging Quantification In Diagnosis Of Erectile Dysfunction

Research purposes:To explore the clinical application value and feasibility of acoustic radiation force impulse imaging(ARFI)’s virtual touch tissue imaging quantification(VTIQ)technology in the diagnosis of different types of vascular erectile dysfunction(ED)and the quantitative evaluation of penile erectile stiffness after intravascular injection(ICI),so as to find a new diagnostic method for ED patients with good diagnostic efficacy,simple,non invasive,lower cost and easier for patients to accept,we analysis and compare the difference of shear wave velocity(SWV)in different types of vascular ED patients,difference of SWV in the same type of ED patients before and after ICI,and the difference of SWV in different degrees of Erection hardness grading scales after ICI,the hemodynamic parameters of ED patients were measured by ICI combined with color Doppler ultrasound(CDU)to insure the type of each ED patient.Subjects and Methods:Patients who complained of ED were included in the urology department of General Hospital of Tianjin Medical University from September 2019 to February2020,the complete medical history and sexual life history of ED patients were collected.All patients were required to fill in the international index of erectile function questionnaire-5(IIEF-5).All patients were examined by ICI combined with CDU.According to the results of hemodynamics,the patients were divided into four groups: arterial ED group(group A),venous ED group(group B)and non vascular ED group(Group C).The penile erectile hardness of the patients was graded by EHGS after ICI,and the patients with ED were divided into 3 groups: EHGS2 group(group X),EHGS3 group(group Y)and EHGS4 group(group Z).The VTIQ mode of ARFI technology was used to measure the bilateral corpus cavernosum of penile of the subjects when penis was weak and after ICI,and the SWV value of the bilateral corpus cavernosum of penile tissue was obtained.Results:28 subjects were included,with an average age of 33.8±8.7 years.1.There were 6 cases in group A,8 cases in group B,12 cases in group C and 2cases were mixed vascularity ED,and all the patients were divided into group X(7cases),group Y(13 cases)and group Z(8 cases)by EHGS.2.The SWV value of corpus cavernosum of penile in group A 、 B and C decreased after ICI test.The SWV value of group A and group B after ICI was higher than that of group C;there was no statistical difference between group A and group C when penis were weak;when penis was weak,group B’s SWV value was higher than group C.3.SWV value was decreased by the increase of EHS level after ICI in group X,group Y and group Z,and the difference between the two groups was statistically significant.SWV value of Y group was lower than that of Group X(t = 2.852,P =0.011);SWV value of group Z was lower than that of group Y(t = 2.725,P = 0.013);SWV value of group Z was lower than that of group X(t = 4.584,P = 0.001).Conclusions:The SWV value of corpus cavernosum of penile of each group patients with arterial,venous and non vascular ED was decreased after ICI;the SWV value of patients with arterial ED and venous ED was higher than that of patients with non vascular ED after ICI;the SWV value of patients with venous ED was higher than that of patients with non vascular ED when penis was weak;the SWV of patients value was decreased with the increase of EHGS grade.The measurement of SWV of corpus cavernosum of penile tissue after ICI by VTIQ is a very valuable and prospective diagnostic method in diagnosis of different types of vascular ED and quantitative evaluation of penile erectile cavernous hardness when penile erection.