Sexual impotent is very common entity and define as inability to induce or maintaining penile erection during sexual intercourse. Studies reveals about 10% of men aged 40-70 years have complete, 17% have mild and 25% have moderate amount of erectile dysfunction.The sexual impotence has different etiology including psychogenic, neurogenic, arteriogenic and venogenic causes.Current studies reveal that organic cause of impotent is a bout 50-90% cases.Among them vascular reasons including arterial insufficiency or venous incompetence contributed 50-70% cases (arteriogenic impotence 30%, venogenic impotence 15% and 25% mixed Venus and arterial).Diagnosis of an organic cause of impotence is very important because is could be curable.The cavernosal arteries are the main feeders to penis and where the erection is performed. Selective angiography with selective internal pudendal is an invasive but the gold standard in evaluation of penile arteries in evaluating arteriogenic impotence.This technique is invasive and is not suitable as a first step or screening examination.Color Doppler imaging could be a suitable technique inassessement of vasculogenic impotence during injection of an intra cavernosal vasodilating pharmacological agent and observing the response.By Color Doppler imaging blood velocity mof cavernosal arteries could be measured before and after intracavernosal injection of vasodilating agents.Also increase in size of the vessel diameter (0.75%) is an indication of normal arterial flow. A suitable vasodilator could be intrcavernosal injection of 60 mg of Papavarine in a 2 ml solution into right or left corpus cavernosum.Alternative drugs are cocktail of triple agent consisting of Papavarine 4.4 mg, phentolamine 0.15 mg and PG-E1.Drug induced priapism may occur in 2-3% of the patients.The patient can be divided into normal, with an average PSV of 47 cm/second, B. Mild to moderate with average peak systolic velocity (PSV) of 35 cm/second and C. Severe arterial insufficiency with an average PSV of 7 cm/second.Generally peak systolic velocity of 40 cm/second was normal.The parameters that indicate the presence of arterial disease are a subnormal clinical response to vasoactive agents, a less than 60% increase in the diameter of the cavernosal artery, and a peak systolic velocity of the cavernosal arteries less than 25 cm/second.In the presence of normal arterial function, Doppler findings suggestive of an abnormal venous leak are persistent end diastolic velocity of the cavernosal artery greater than 5 cm/second and demonstration of flow in the deep dorsal vein.The development of diastolic flow reversal after an injection has been found to be a reliable indicator of venous competence.In conclusion Color duplex Doppler ultrasoung with intracavernosla injection of vasodilator. Sonography is an excellent and accurate means of assessing patients with erectile dysfunction. It is a minimal invasive test with low complication rate and can produce good results and should replace angiography and cavernosometry as primary or screening test.

Background: The purpose of our study was to assess the potential of Color Doppler (CD) and Power Doppler Imaging (PDI) to differentiate benign from malignant solid breast masses. Materials and Methods: Seventy-one biopsy proven solid breast masses were evaluated with CD and PDI using 7.5MHz Transducer. Vascularity, Resistive Index (RI) and patterns of vascular distribution of masses were assigned before biopsy. Results: There were 22 cancers and 49 benign lesions. All malignant masses had vascularity in some degrees, except 3 cancers which were less than 10 mm in diameter. Most of cancers were hypervascular (15 cancers) and had penetrating or diffuse vessels (14 cancers). Most of benign lesions and fibro adenomas were avascular (35 masses). 12 cancers, 2 fibro adenomas and all vascular benign lesions had RI>0.6. 7 cancers and 6 fibro adenomas had RI<0.6. By using hypervascularity to indicate malignancy sensitivity for CD and PDI was 68 percent and specificity was 90 percent and by using penetrating and diffuse vessels sensitivity was 64 percent and specificity was 82 percent. By using RI<0.6 sensitivity was 32 percent and specificity was 88 percent and by using these three criteria together sensitivity was 73 percent and specificity was 82 percent (p<0.00001). Conclusion: The vascularity and pattern of distribution and morphology of blood vessels in solid breast masses seen at PDI and CD is a potentially important feature to predict the likelihood of malignancy. But RI appears to be of limited value.

Background/Objective: The orbit is one of the most important organs involved in many pathologic conditions. Hemodynamic alterations play an important role in the pathogenesis of some of these conditions such as diabetic retinopathy .Hemodynamic alterations in the orbit may be evaluated by different methods. Color Doppler imaging (CDI) is one of the useful methods that introduces real-time information and is a non-invasive, safe and inexpensive technique. There are few investigations about normal CDI indices in normal orbital vessels so we used CDI in this study to obtain the values of these indices in normal eyes.Patients and Methods: The ophthalmic artery (OA), posterior short ciliary artery (PSCA), central retinal artery (CRA) and central retinal vein (CRV) were examined and the peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were measured for each vessel.Results: This was a cross sectional study. One eye of 26 healthy individuals, including 13 males and 13 females were included in this study. The mean age was 45.5 years and the following findings were obtained:OA: PSV (9.32+30.7), EDV (3.13+7.66), PI (0.42+1.73), RI (0.05+0.75)PSCA: PSV (4.2+3.41), EDV (1.76+4.84), PI (0.20+1.05), RI (0.06+0.65)CRA: PSV (4.05+11.9), EDV (1.28+3.99), PI (0.35+ 1.32), RI (0.07+0.69)CRV: PSV (1.26+5.09), EDV (0.08+3.72)Conclusion: We believe that CDI is a useful, safe and reproducible imaging technique for evaluating the hemodynamics of orbital vessels.

Usage of Color Doppler ultrasound in the diagnosis of uteroplacental or fetal-placental vascular insufficiency is based on the theory that many of these insufficiencies are due to small vessel disease in the uteroplacental or fetal-placental vasculature which ultimately results in fetal intrauterine growth retardation, increase in prenatal mortality and morbidity and fetal neurological development. In a prospective study on patients who were sus-pected for developing uteroplacental insufficiency, Color Doppler ultrasound was done and the results were compared with neonatal weight (one of the most important criteria for IUGR determination) which was measured just after delivery.Direct significant relation was showed to be present between prepartum vascular changes detected in Doppler ultrasound and prognosis of IUGR. Three vessel types were assessed in this study:1. Umbilical-middle cerebral arteries2. Uterine arteries3.Venous system (umbilical, ductus venosus, IVC), which is used to assess the compensation process in fetal circulation.Three Doppler indices of vascular resistance were studied and their abnormalities according to the age of pregnancy were assessed.

Background: Although Color Doppler Ultrasonography (CDUS) is useful in the diagnosis of various diseases of the head and neck, flow signals in oral malignant masses are less studied; hence the present study assesses the usefulness of Color Doppler Ultrasonography in quantifying oral squamous cell carcinoma (OSCC) vascularization. In addition, we determine the hemodynamic parameters by spectral analysis obtained during a Color Doppler Ultrasonography procedure. We have studied the usefulness of Color Doppler Ultrasonography in mapping oral squamous cell carcinoma of the buccal mucosa, tongue and lip.Methods: This case-control study enrolled 60 subjects aged 20-70 years. Group A constituted 30 cases diagnosed with oral squamous cell carcinoma and Group B constituted 30 healthy controls. Ultrasonographic investigation of each mass was performed. The spectral waveform (time-velocity Doppler spectrum) of the flow signal was analyzed for the pulsatility index, resistive index, peak systolic velocity (m/sec), and end diastolic velocity (m/sec). All patients had real-time, gray-scale sonography and Color Doppler Ultrasonography with spectral wave analysis.Results: The mean value for the resistive index in patients with oral squamous cell carcinoma was 0.40±0.14 whereas for healthy subjects, it was 0.83±0.07. The mean pulsatility index value in malignant patients was 0.86±0.20 while for healthy subjects, it came-out to be 2.61±0.77.Conclusion: These Doppler indices have been shown to be sensitive and specific for the diagnosis of malignant oral tumors. Although Color Doppler Ultrasonography cannot replace histopathological procedures, it plays a definite role as an adjunct to clinical evaluation of oral squamous cell carcinoma patients.

Introduction: The introduction of Color Doppler Ultrasonography has improved the evaluation of vertebral arteries. This study was designed to determine normal values of hemodynamic parameters in second segment of vertebral artery in healthy old people.Materials & Methods: We performed a prospective study in 31 healthy adults from 60 to 96 years old. Angle corrected flow velocities and luminal diameters were measured and waveform parameters calculated in all vertebral arteries.Results: It was possible to visualize V2 Segment in 100% and origin of right VA in 72% and origin of left VA in 59% of them. Mean diameter of right VA was 32.4± 0.56 mm while it was 3.52± 0.67 mm for the left VA. The resistance index in right VA was 0.71±0.08 and it was 0.69±0.06 in the left VA. There were no significant differences between the two sides.Peak systolic velocity was 35.77±12.71 cm/s on the right and 36.29±12.71 cm/s on the left. Accordingly, no differences were observed between the two sides.Conclusion: This study and its presented reference values can lead to better differentiation between normal and pathologic findings in vertebral arteries among old people. Nevertheless, further studies are needed to determine the normal and pathologic values of vertebral arteries.

Introduction & Background: Color Doppler ultrasonography (US) is the imaging modality of choice in patients with penile diseases. Ultrasonography has a well-established role in evaluating erectile dysfunction as well as penile trauma, scarring, deformity, and tumors. The normal postoperative anatomy and the pathologic changes that can occur in cases of surgical complications can be successfully investigated with US. Gray Scale (B Mode) and Color Doppler US clearly depicts the normal penile anatomy and postoperative changes. It is also effective in evaluating surgery-related complications and determining the causes of erectile dysfunction and other un-satisfactory long¬term results. Color Doppler US is the imaging modality of choice in evaluating patients who have undergone penile surgery. Here we aim to illustrate the gray-scale and Color Doppler US appearance of normal penis, discuss the main penile surgical procedures, recognize the typical US features of the postopera-tive penis, and describe the US appearance of various postoperative complications. Patients & Methods: This article is the result of evaluating 42 patients referred to the radiology ward of Hashemi-Nejad Hospital, Iran University of Medical Sciences in the years 2002 to 2005 for ultrasonography of penis to assess the penis after different penile surgical procedures (urethral surgery, correction of penile mal-formations, prosthesis implantation, vascular surgery for impotence, surgical management of priapism, phallic reconstruction). The US apparatus was Esaote Technos MP, with linear multifrequency 5-8.5MHz. transducer. Results: A variety of early and late surgical complications could be identified, such as extraalbugineal patho-logic fluid collections and fibrosis. Moreover, Doppler US of the penile vessels and vascular anastomoses fol-lowing revascularization allowed direct evaluation of flow characteristics, shunt patency, and venous en-gorgement. Color Doppler US was also particularly helpful in determining the causes of erectile dysfunction and other unsatisfactory long-term results following penile surgery. Conclusion: Our findings indicate that Color Doppler US is the imaging modality of choice in evaluating pa-tients who have undergone penile surgery because it clearly depicts normal penile anatomy and postoperative changes. 

Introduction. Early diagnosis of diabetic nephropathy (DN), the leading cause of death in diabetic patients, is an important issue in preventing and reducing the disease burden for patients and the healthcare system. In this study, we aimed at investigating the value of Color Doppler ultrasonography in the diagnosis of early diabetic nephropathy (DN). Methods. Two hundred and thirty-eight diabetic patients, were enrolled in this study and were categorized into, either control (n = 109) or study group (n = 129), according to 24 hours urinary albumin excretion rate (UAER), from January 2015 to March 2021. The morphologic findings of the kidneys were observed and compared, in both groups, by Color Doppler ultrasound technique, and blood flow of renal arteries was also measured, at all levels. Fasting plasma glucose (FPG), uric acid, homocysteine, beta-2-microglobulin, cystatin C, hemoglobin A1c (HbA1c) and CRP were also extracted from their laboratory results. Results. Compared to the control group, the study group had lower intrarenal arterial end-diastolic blood flow velocity (EDV) and higher arterial resistance index (RI) (P ~ <. 05). A significant diagnostic value of intrarenal arterial EDV and RI was found for early detection of DN (P ~ <. 05). Intrarenal arterial RI and EDV showed positive correlations with UAER, FPG, uric acid, homocysteine, beta-2-microglobulin, cystatin C, HbA1c, and CRP (P ~ <. 05). Conclusion. Color Doppler ultrasound markers of renal and intrarenal arteries has a high diagnostic value for DN at its early stage.

Background: Diagnosis of transient ischemic attack within the territory of vertebral arteries is difficult owing to diversity of clinical symptoms. CT scans or MRI may be of little help in arriving at diagnosis. Although angiography can detect vertebral artery lesions, it is an invasive and expensive procedure. Doppler echo sonography of the vertebral artery can provide useful information regarding the presence and extent of ischemia, as well as the velocity and flow of blood in the artery.Patients and Method: This observational case-control study was conducted between 1995 and 1999 at AIZahra Hospital, Isfahan, in order to investigate the status of vertebral artery in patients with transient ischemic attacks within the perfusion territory of the vertebral arteries. Carotid artery diameter, as well as the velocity and blood flow were measured by Doppler echo sonography in 100 patients presenting with vertebrobasilar artery insufficiency and 100 controls.Results: Mean diameter of right common carotid, left common carotid, right vertebral and left vertebral artery in the control group measured 6.8 mm, 6.9 mm, 3.3 mm and 6.0 mm. Vertebral artery blood flow in the case group was significantly higher than in the control group (P<0.005).The ratio of measured parameters in the two groups also showed significant differences between the two groups (P>0.001). The carotid/vertebral ratio index was also significantly different (P>0.001).Discussion: The sensitivity and specificity of the aforesaid indices in detecting vertebrobasilar artery ischemia measured (77.8% and 90% respectively) suggests that Doppler sonography of carotid and vertebral arteries is a reliably sensitive and specific method for detection of ischemia within the perfusion territory of the vertebral arteries.