Department of Urology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Urology. 2010 Jan;75(1):112-6. doi: 10.1016/j.urology.2009.05.102. Epub 2009 Nov 20.
To review the associations between measured variables in Penile Doppler ultrasound procedures. Penile Doppler ultrasound is useful in the evaluation of erectile dysfunction, but there is no uniform standard of performing the procedure. It is generally believed that a peak systolic velocity > 30 cm/s, minimal venous leak, and resistive index > 0.8 are essential for adequate erection. While the arterial parameters are well studied, data on the predictive value of time to peak flow are lacking.
Penile duplex Doppler ultrasounds performed for either erectile dysfunction or Peyronie's disease evaluation were reviewed. Clinical records, International Index of Erectile Function scores, and ultrasound variables were examined. "Fast" responders reached maximal peak systolic velocity (PSV) < or = 10 minutes, whereas "slow" responders reached maximal PSV between 15 and 25 minutes.
Of 146 total patients, 36 (25%) were fast responders and 110 (75%), slow responders. No preprocedural characteristics, including the Erectile Function domain score of the International Index of Erectile Function, predicted time to peak flow. Compared with the fast responders, slow responders had higher mean PSV (left: 33.9 +/- 19.5 vs 25.0 +/- 11.7 cm/s, P = .01; and right: 36.4 +/- 21.3 vs 25.0 +/- 13.3 cm/s, P = .002). There was also a higher percentage of patients with average PSV > 30 cm/s in slow responders (58% vs 36%, P = .02).
There were no significant differences in baseline characteristics between slow and fast responders. However, slow responders did seem to have significantly better arterial flow parameters, although penile dimensions, cavernosal artery diameter, Erectile Function domain scores, and subjective rigidity were similar.
探讨阴茎多普勒超声检查中各测量变量之间的相关性。阴茎多普勒超声在勃起功能障碍评估中具有重要作用，但目前该检查操作尚未形成统一标准。通常认为，收缩期峰值流速（PSV）＞30cm/s、最小静脉漏、阻力指数（RI）＞0.8 是勃起充分的必备条件。目前已有大量关于动脉参数的研究，但关于峰值血流时间的预测价值的数据尚缺乏。
回顾分析了因勃起功能障碍或阴茎硬结症行阴茎双功能多普勒超声检查的患者资料。分析内容包括临床记录、国际勃起功能指数评分（IIEF）和超声变量。“快速”反应者为在＜10 分钟内达到最大 PSV，“缓慢”反应者为在 15-25 分钟内达到最大 PSV。
146 例患者中，36 例（25%）为“快速”反应者，110 例（75%）为“缓慢”反应者。包括 IIEF 勃起功能域评分在内的各项术前特征均不能预测峰值血流时间。与“快速”反应者相比，“缓慢”反应者的平均 PSV 更高（左侧：33.9±19.5cm/s 比 25.0±11.7cm/s，P=0.01；右侧：36.4±21.3cm/s 比 25.0±13.3cm/s，P=0.002），PSV＞30cm/s 的患者比例也更高（58%比 36%，P=0.02）。
“快速”反应者和“缓慢”反应者的基线特征无显著差异，但“缓慢”反应者的动脉血流参数似乎更好，尽管阴茎尺寸、海绵体动脉直径、IIEF 勃起功能域评分和主观硬度等方面无显著差异。
