Differences in Cavernosal Artery Parameters According to Different Anatomic Sampling Locations During the Diagnosis of Vascular Erectile Dysfunction Using Duplex Ultrasound

Application of Superb Microvascular Imaging in the Diagnosis of Vascular Erectile Dysfunction

To compare the difference between superb microvascular imaging (SMI) and color doppler flow imaging (CDFI) on vascular grading and blood flow display rate of the penile cavernous artery of vascular erectile dysfunction (ED), and to evaluate the length of time to obtain blood flow spectrum. 68 patients with ED were preformed for the examination of SMI and CDFI. The difference between the two techniques on vascular grading and blood flow display rate were compared. Hemodynamic parameters, namely peak systolic velocity (PSV), end diastolic velocity (EDV), and resistant index (RI) and the length of time obtained blood flow spectrum were compared. SMI was more sensitive to assess vascular grading and blood flow display rate than CDFI (P < 0.05). Hemodynamic parameters (PSV, EDV, and RI) measured by SMI and CDFI were well correlated (r = 0.981, P < 0.001; r = 0.879, P < 0.001; r = 0.937, P < 0.001). The duration of time necessary obtained the spectrums of grade 3 and grade 4 blood flow was shorter than that of grade 1 and grade 2, and SMI was comparatively shorter than CDFI (P < 0.05). In conclusion, SMI detected the blood flow of the penile cavernous artery better and maked the examination time shorter than CDFI, which can be considered as a more effective technique to diagnose vascular ED.

Cavernous artery intima-media thickness predicts the response to sildenafil in erectile dysfunction patients as a morphological parameter

While the intima-media thickness (IMT) of the cavernous artery was used for diagnosis for vascular erectile dysfunction (ED) with more accuracy than the peak systolic velocity, the role of the IMT in predicting treatment responses remained unexamined. A total of 136 patients with ED were enrolled. The baseline clinical and laboratory characteristics were collected. Penile Doppler ultrasonography (PDU) was performed on all patients by a blinded sonographer. Sildenafil was administrated to all patients with an adjusted dose of 50 or 100 mg on demand over a period of 3 months. A follow-up was conducted on all patients using the Erectile Hardness Score (EHS) questionnaire along with the visual and tactile version of the standardised EHS tool. The peak systolic velocity (PSV) and IMT were compared between sildenafil responders and sildenafil nonresponders, while receiver operator characteristic (ROC) curves were used to calculate the cut-off values and compare the test power respectively. There was no statistical difference from the baseline characteristics. The IMT of cavernous artery was more accurate than PSV to predict the sildenafil response (AUC = 0.809, 0.626 respectively). IMT could predict sildenafil responders more accurately than PSV, and the cut-off value of the IMT of the cavernous artery was less than 0.22 mm.