[Penile hemodynamics in different erection phases].

OBJECTIVE: To compare the hemodynamic indexes of penile cavernosal arteries in different phases of penile erection and determine the optimal time for color Doppler ultrasonography of the penis. METHODS: Forty healthy adult male volunteers with normal erectile function received intracavernous injection of 10 µg Alprostadil together with visual and auditory stimuli. Within the next 30 minutes, we monitored dynamically the blood flow in the bilateral penile cavernosal arteries, and recorded and compared the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) in the phases of latency, tumescence, full erection and rigid erection. RESULTS: Fourteen of the subjects experienced latency, tumescence and full erection only, but failed to achieve rigid erection. PSV and RI were significantly higher while EDV remarkably lower in the tumescence and full erection phases than in the latency phase (all P < 0.01). Statistically significant differences were observed between the tumescence and full erection phases in EDV and RI (both P < 0.01) but not in PSV (P > 0.05). Among the 26 males that achieved rigid erection, PSV, EDV and RI showed significant differences between the full and rigid erection phases (all P < 0.01), but not between the left and right cavernosal arteries in the same phase (P > 0.05). CONCLUSIONS: The blood flow in the penile cavernosal arteries changes dynamically in the process of penile erection, and the hemodynamic indexes obtained in the full erection phase can better reflect the function of penile cavernous vessels.

Application of contrast enhanced ultrasound in gallbladder lesion: is it helpful to improve the diagnostic capabilities?

The aim of this study is to evaluate if contrast enhanced ultrasound (CEUS) can improve the differential diagnostic performance of gallbladder (GB) lesions. MATERIALS AND METHODS: Forty-nine patients (18 men, 31 women; mean age, 54.8±14.4 years, range age, 22-78 years) with GB lesions (mass-forming and wall-thickened types) were enrolled in this study. All patients underwent conventional ultrasonography (US) and CEUS examination. The imaging characteristics of GB lesions were analyzed to compare the diagnostic performance of US and CEUS. The final diagnosis was obtained by histopathology. RESULTS: There were significant differences between benign and malignant GB lesions with regards to size, shape, vascularity, the integrity and margin of GB wall and time to iso-enhancement on CEUS (p<0.05). However, no significant difference was found concerning the enhancement patterns between the two groups (p>0.05). Logistic regression analysis showed that the boundary between liver and GB wall (p=0.017) and vascularity on color Doppler flow imaging (p=0.013) were two independent predictors of malignancy. The diagnostic accuracy of US could be improved in combination with CEUS (65.3% vs 83.7%). The diagnostic accuracy of the GB wall thickening type was higher than the mass forming type. CONCLUSION: CEUS could improve the diagnostic performance of GB lesions, especially for wall-thickened type lesions.