No abstract available.
Diagnosis* ; Female ; Impotence, Vasculogenic* ; Male ; Ultrasonography, Doppler, Duplex*

PURPOSE: The aims of this study were to evaluate whether vardenafil, a phosphodiesterase type 5 inhibitor, may be used as a substitute for intracavernosal injection when assessing erectile dysfunction using penile duplex Doppler ultrasonography. MATERIALS AND METHODS: A total of 21 patients with erectile dysfunction underwent penile duplex Doppler ultrasonography after intracavernosal injection of 0.2 ml trimix. Each patient also underwent penile duplex Doppler ultrasonography after a 10-mg oral dose of vardenafil with audio-visual sexual stimulation. There was 1 week interval between each study. In both studies, peak systolic velocity, end-diastolic velocity, and resistive index were measured. Then ultrasonographic diagnoses of erectile dysfunction were classified as arteriogenic, veno-occlusive, and mixed-type. RESULTS: Doppler ultrasonography with trimix intracavernosal injection identified 8(38.1%), 1(4.8%), 10(47.6%), and 2(9.5%) patients with arteriogenic, veno-occlusive, mixed-type, and non-vasculogenic impotence, respectively. After vardenafil oral medication, 10(47.6%), 1(4.8%), and 10(47.6%) patients demonstrated arteriogenic, veno-occlusive, and mixed-type impotence, respectively. There was a difference in diagnosis in 23.8% of cases. CONCLUSIONS: Vardenafil oral administration with audio-visual sexual stimulation showed a similar hemodynamic result compared to trimix intracavernosal injection during penile duplex Doppler ultrasonography. However, there were some differences. These results suggest that vardenafil oral medication may be used as a substitute for intracavernosal injection when assessing erectile dysfunction using penile duplex Doppler ultrasonography. However, further investigation is needed.
Administration, Oral ; Diagnosis ; Erectile Dysfunction* ; Hemodynamics ; Humans ; Male ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Duplex* ; Vardenafil Dihydrochloride

The authors report a patient with a small traumatic cirsoid aneurysm of the scalp, diagnosed by duplex doppler ultrasonography. This 15-year-old boy was diagnosed as a cirsoid aneurysm by duplex doppler ultrasonogram which revealed an ovoid cystic lesion at left temporal area of scalp containing vascular flow mapping. The gross appearance showed an aneurysm with arteriovenous fistula, consisting of two feeding arteries and two draining veins. Total removal of mass was made and the histological examination revealed an aneurysm which showing irregular contour of inner surface and thickened fibrotic vascular wall without normal arterial layers. Noninvasive duplex doppler ultrasonography before surgical excision or direct puncture embolization of cirsoid aneurysms of the scalp could be recommended as an alternative management option.
Adolescent ; Aneurysm* ; Arteries ; Arteriovenous Fistula ; Humans ; Male ; Punctures ; Scalp* ; Ultrasonography ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Duplex ; Veins

PURPOSE: Female sexual dysfunction may have its origin in abnormal blood flow into the clitoris during sexual stimulation. There have been few studies to measure the clitoral blood flow by color duplex Doppler ultrasonography. The goal of this study was to evaluate the diagnostic values of clitoral color duplex Doppler ultrasonography with audiovisual sexual stimulation (AVSS). MATERIALS AND METHODS: Clitoral color duplex Doppler ultrasonography was performed during AVSS with glasses-type monitor. A total of fourteen women were included in the study; five premenopausal volunteers (mean age; 35, range; 24-50), five sexual arousal disorder patients (mean age; 38, range; 31-45) and four menopausal volunteers (mean age; 53, range; 47-56). Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of clitoral cavernosal arteries were measured during AVSS in each patients. RESULTS: In the premenopausal volunteer group, PSV of clitoral arteries (mean SD) showed 38.7 +/- 9.7cm/sec, EDV 14.9 +/- 3.2cm/sec, RI 0.59 +/- 0.04, respectively. PSV of clitoral arteries decreased to 27.3 9.6cm/sec in sexual arousal disorder group, 18.1 +/- 6.5cm/sec in menopausal group. PSV significantly decreased in menopausal group (p<0.05) compared to the premenopausal volunteer group, but RI did not be changed significantly. CONCLUSIONS: These results suggest that clitoral duplex Doppler ultrasonography with AVSS may be used to evaluate clitoral arterial function in the female sexual dysfunction patients. However, further studies are needed in a large group to define normal clitoral blood flow parameters.
Arteries ; Clitoris ; Female ; Humans ; Sexual Dysfunctions, Psychological ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Duplex* ; Volunteers

PURPOSE: Retrograde flow is the main criterion for the diagnosis of varicocele, and the Duplex Doppler ultrasonographic values for retrograde flows are poorly defined. The purpose of this study is to assess a relationship between the palpated varicocele and pampiniform plexus diameter and the retrograde flow that was investigated with performing Duplex Doppler ultrasonography (DDU). MATERIALS AND METHODS: Physical examinations and DDU were performed to assess varicoceles in forty patients with left-sided varicocele and also in eight men who were without varicocele on their physical examination. During both normal respiration and the Valsalva's maneuver, the maximum diameters of the pampiniform plexus and the presence of the retrograde flow were measured by DDU. RESULTS: The highest mean venous diameter in the patients with clinical grade III varicocele was 2.7mm (2.4-3.6), and this was significantly higher than that in the patients with grade I (1.9mm) or with grade II varicocele (2.1mm) (p<0.05). While the difference of diameters between grade I and grade II was not significant, venous reflux was found in all degrees of the varicocele veins. Venous reflux during the Valsalva maneuver (type II flow pattern) was detected on the right side in one (8%) of 13 patients with grade II varicocele, and in three (21%) of 14 patients with grade III varicocele. The type III flow patterns, indicating augmenting of the reflux with an intra-abdominal pressure increase, were 46.1%, 69.2% and 100% for grade I, II and III, respectively. No venous reflux was found in the control group. CONCLUSIONS: The presence of retrograde flow may provide a more reliable indicator than does the spermatic vein diameter for the diagnosis of varicocele. When the palpability of the pampiniform plexus is questionable, Duplex Doppler ultrasound is indicated.
Diagnosis ; Humans ; Male ; Physical Examination ; Respiration ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Valsalva Maneuver ; Varicocele* ; Veins

PURPOSE: The Giacomini vein (GV) is one of branches that arising from the short saphenous vein (SSV) which extends cephalad along the posterior thigh communicating to the great saphenous vein (GSV), GSV branch or deep venous system. Despite of its common occurrence, the clinical significance of this venous structure isunknown yet. We investigated the frequency and the anatomical feature of the GV and the frequency of superficial or deep venous reflux associated GV to clarify its clinical significance. METHOD: We conductednon-invasive vascular evaluations on both legs using duplex ultrasonography in 50 patients having leg varicosity or telangiectasis. RESULT: 16 patients (32%) of 50 patients[28 limbs (28%) of 100 limbs]revealed the GV in their lower extremities. Among the patient with GV, venous refluxes of GSV, SSV or perforating vein (PV) were noted in frequencies of 16 limbs (76%), 8 limbs (38%) and 9 limbs (42%) respectively. The SSV and PV reflux were more common in the legs with GV than the legs without GV (P<0.001 respectively, McNemar test) regardless the existence of GV reflux. CONCLUSION: The SSV or PV reflux was more commonly associated with GV.
Extremities ; Humans ; Leg ; Lower Extremity ; Saphenous Vein ; Telangiectasis ; Thigh ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Veins*

PURPOSE: The Giacomini vein (GV) is one of branches that arising from the short saphenous vein (SSV) which extends cephalad along the posterior thigh communicating to the great saphenous vein (GSV), GSV branch or deep venous system. Despite of its common occurrence, the clinical significance of this venous structure isunknown yet. We investigated the frequency and the anatomical feature of the GV and the frequency of superficial or deep venous reflux associated GV to clarify its clinical significance. METHOD: We conductednon-invasive vascular evaluations on both legs using duplex ultrasonography in 50 patients having leg varicosity or telangiectasis. RESULT: 16 patients (32%) of 50 patients[28 limbs (28%) of 100 limbs]revealed the GV in their lower extremities. Among the patient with GV, venous refluxes of GSV, SSV or perforating vein (PV) were noted in frequencies of 16 limbs (76%), 8 limbs (38%) and 9 limbs (42%) respectively. The SSV and PV reflux were more common in the legs with GV than the legs without GV (P<0.001 respectively, McNemar test) regardless the existence of GV reflux. CONCLUSION: The SSV or PV reflux was more commonly associated with GV.
Extremities ; Humans ; Leg ; Lower Extremity ; Saphenous Vein ; Telangiectasis ; Thigh ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Veins*

PURPOSE: The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. METHODS: Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. RESULTS: Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (P<0.001). CONCLUSION: Duplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.
Diagnosis ; Humans ; Lower Extremity* ; Mass Screening ; Peripheral Arterial Disease ; Smoke ; Smoking ; Ultrasonography ; Ultrasonography, Doppler, Duplex

PURPOSE: To compare the efficacy and availability of foot pump and active ankle exercise for preventing deep vein thrombosis after total knee arthroplasty with hemodynamic evaluation using a color doppler duplex ultrasonography. MATERIALS AND METHODS: Thirty-six patients who underwent total knee arthroplasty between Oct. 2005 and Apr. 2006 were enrolled in this study. Retrospective analysis of 36 patients(Group 1 - foot pump after TKA, 18; Group 2-passive ankle exercise, 18) was conducted and all patients underwent color doppler duplex ultrasonography preoperatively and postoperative 7 to 14 days at femoral, popliteal and calf vein and the hemodynamic status was assessed. RESULTS: The mean baseline velocity was decreased postoperatively in both group, at all veins, but the mean peak velocity was increased only in Group. In Group 1, mean flow ratio was increased, but in Group 2, mean flow ratio was decreased except femoral vein. There were significant differences between Group 1 and Group 2(p<0.05). CONCLUSION: This study demonstrated that foot pump may be more effective than active ankle exercise in preventing postoperative deep vein thrombosis due to more increased venous flow rate and foot pump may be more compliable than active ankle exercise due to less painful, more convenient, so foot pump can be one of the available method for preventing DVT after total knee arthroplasty.
Ankle ; Arthroplasty* ; Femoral Vein ; Foot* ; Hemodynamics ; Humans ; Knee* ; Retrospective Studies ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex ; Veins ; Venous Thrombosis*

PURPOSE: Intracavernosal injection subsequent vibrotactile or audiovisual sexual stimulation (AVSS) have frequently been utilized to produce al maximal erectile response during penile Doppler ultrasonography. However, several studies have shown that erectile quality often decreases following the placement of the sonographic probe. We examined whether real-time AVSS with an eyeglasses-type monitor enhances quality during penile duplex color Doppler ultrasonography. PATIENTS AND METHODS: A total of 32 impotent patients underwent penile duplex color Doppler ultrasonography of the cavernosal arteries after intracavernosal injection of 10 to 20 microgram of prostaglandin E1 and subsequent manual stimulation. Real-time AVSS sas used when the patient failed to achieve a rigid erection or showed abnomal arterial blood flow. The clinical erectile response was assessed by visual inspection and palpation and graded from I to V. Peak blood flow velocities and resistance index of the both cavernosal arteries were monitored continuously. After AVSS, the sexual drive was assessed as grade I (poor), II (moderate), or III (good). RESULTS: After intracavernosal injection and genital stimulation, 3 patients (9%) had a Grade II erection, 2 (6%) a Grade III, 16 (50%) a Grade IV, and 11 (34%) a Grade V. During duplex ultrasonography, 4 patients (13%) had a Grade II erection, 7 (22%) a Grade III, 16 (50%) a Grade IV, and 5 (16%) an arade V. During real-time AVSS, 22 patients (69%) showed better drectile quality. Initial Doppler ultrasonographic scanning showed arteriogenic impotence in 9 patients (28%), veno-occlusive disease in 5 (16%), and mixed arteriogenic and venogenic impotence in 18 (25%), veno-occlusive in 9 (28%), and mixed type in 2 (6%). Therefore, the initial diagnosis turned to be different after AVSS in 26 patients (81%). The sexual drive was rated grade I in 9 (28%), grade II in 11(34%), and grade III in 12 (38%). CONCLUSION: Real-time AVSS with an eyeglasses-type monitor remarkably enhances the quality of pharmacologically induced erections. Such stimulation may be useful during penile color Doppler ultrasonography to help in making the ccorrect diagnosis of the cause of erectile dysfunction.
Alprostadil ; Arteries ; Blood Flow Velocity ; Diagnosis ; Erectile Dysfunction ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Palpation ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex*