The Effect of Measurement Location of the Blood Flow Parameters on Their Values During Penile Duplex Sonography

Chung, Woo Sik; Park, Young Yo; Baek, Seung Yeon

Abstract

Although several reference values of the cavernosal arterial flow velocity were reported for defining the normal vascular condition including good arterial inflow and corporal venoocclusive function, still we have some confusions and limitations to interpret the results because of lack of standardization of some various factors relating to performing duplex scanning. Here in, we evaluated the effect of cavernosal arterial location that is measured by Doppler spectrum on the values of blood flow velocity. 36 patients with suspecting vasculogenic impotence entered the study. Color duplex sonography was performed in all patients. We obtained velocity measurements at 3 to 8 min intervals in both cavernosal arteries for at least 20 min after injection of PGE1 10ug. The cavernosal artery peak systolic flow velocity (PSV) and end diastolic flow velocity (EDV) were measured at two portions. the base over the ascending portion of cavernosal artery( 'Proximal') and midshaft( 'Distal') of the penis in each session. We classified the patients based on the results of Proximal values of duplex parameters into normal(maximal PSV>30 cm/sec and minimal EDV<5cm/sec throughout the study; NL group: n=8), arterial insufficiency with or without venous incompetency(maximal PSV< 25cm/sec; AI group: n=l2) and venous incompetency without arterial insufficiency(maximal PSV>30cm/sec and minimal EDV>5cm/sec; VI group n= 16). When we compared PSV values between two portions of measurement in each group all the Distal PSV values were significantly lower than Proximal(p<0.06) in NL and VI group, but no statistical difference was noted in PSV values of AI group(p>0.05). If we considered only Distal values for patient grouping 63% of VI group and 50% of NL group had maximal PSV values less than 25cm/sec that would be reclassified into arterial insufficiency. On the other hand, resistance index(RI) values remained unchanged regardless of measurement location in all groups. With the above results we can conclude that there is an obvious difference of blood flow velocities between two portions of measurement(Proximal vs Distal) and Proximal value is more reliable than Distal when we diagnose with previously reported normal reference value (PSV>30-35cm/sec).