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.

Accurate assessment of gestational age, fetal growth, and the detection of fetal and placental abnormalities are major benefits of sonography. Color Doppler can be used to assist in the identification of vascular architecture, detection of vascular pathology and visualization of blood flow changes associated with physiologic processes and disease states.The clinical applications of obstetrical Doppler are Intrauterine Growth Restriction, diagnosis of fetal anemia and twin-twin transfusion syndrome.The use of Doppler during antenatal fetal surveillance has involved assessment of (1) the umbilical arterial and venous flow velocity waveforms, (2) the fetal cerebral circulation, and (3) the fetal venous circulation, in particular the ductus venosus.Doppler studies of the fetal circulation in intrauterine growth retardation and hypoxia have demonstrated increased resistance to flow in the umbilical arteries and redistribution in the fetal circulation with reduced resistance and increased velocity in the internal carotid and middle cerebral artery and the opposite in the descending thoracic aorta.Assessment of placental function using umbilical artery Doppler velocimetry: Placental insufficiency can be quantified based on the reduction of end-diastolic Doppler flow velocity into (1) reduced end diastolic flow velocity, (2) absent end-diastolic flow velocity, and (3) reversed end-diastolic flow velocity.Use of middle cerebral artery velocimetry to detect fetal hypoxia: an increase in pCO2 or a reduction in pO2 will cause an increase in fetal cerebral arterial Doppler end-diastolic flow velocity, likely related to cerebral vasodilatation.This phenomenon has been described as the “brain sparing” effect.Use of Doppler to detect fetal anemia: The MCA-PSV is an accurate predictor of severe fetal anemia in pregnancies complicated by red cell alloimmunization.Use of uterine artery Doppler to detect maternal complications of pregnancy: The uterine artery Doppler reflects fetal response to stress of hostile intrauterine environment (pregnancy induced hypertension, re-eclamptic toxemia).Fetal venous flow: The umbilical vein, ductus venosus and the inferior vena cava are the main areas of interest in the investigation of venous blood return to the fetal heart.Pulsatile umbilical vein flow and back flow in ductus venosus and IVC are indications advanced cardiac decompensation.

Considering that more than 85 percent of ischemic strokes take place in the territory of middle cerebral artery and Transcranial Doppler Sonography (TCD) is a sensitive and non aggressive method for detection of flow of cranial vessels, the aim was assessing flow alterations of these arteries in ischemic strokes of middle cerebral artery (MCA) to enable an accurate and quick method to for cast happening of any stroke and it's Prognosis. In this study, designed in descriptive method, the anterior circulation arteries of 44 patients who suffered ischemic infarction in the territory of MCA were insonated by TCD. Patients with first stroke were included and sampling was non probability testing on consecutive patients. Brain axial CTS can was performed on all patients on first and third days of stroke and TCD was performed on days 3 to 6 and the results were as following: Peak Systolic Velocity (PSV) and Mean Flow Velocity (MFV) of ipsilateral MCA were reduced resulting in asymmetry of flow more than 15% in 61.4% of cases (P value <0.005) . PSV and MFV of ACA were increased resulting in increased ratio of ipsilateral to contralateral ACA (ACAVR) in 72.2% of cases. (P value < 0.005) Pulsatility index (PI) of ipsilateral MCA to contralateral MCA had a significant increase. (P value=p.005) indicating distal vascular resistance. Resistance Index (RI) of ipsilateral MCA and contralateral MCA didn't have any significant difference (P value = 0.05) 1- Ischemic MCA infarcts reduce PSV, MFV in ipsilateral MCA and increase PSV, MFV in ipsilateral ACA, resulting in increased ipsilateral ACAYR. 2- The most valuable parameter in determining MCA infarct is ACAVR (Sensitivity=72.2%), the next one being MCA flow asymmetry> 15% (Sensitivity=61.4%) 3- RI Value had no relation to the final size of infarct. Further studies evaluating normal values of TCD parameters in Iranian people are recommended to compare these indexes with normal ones.  

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 - Myocardial longitudinal shortening play an important role in cardiac contraction. Tissue velocity imaging (TVI) is an ultrasonographic technique that measure myocardial motion and providing a quantitative agreement of left ventricular regional myocardial function in different modalities. The present review discusses the most recent development in the application of TDI in coronary artery disease.Methods - Seventy patients with myocardial infarction (transmural and nontransmural) were included in the study. These subjects were diagnosed with recent myocardial infarction according to electrocardiography, cardiac enzymes and history. The basal segments of septal wall (septal side of mitral annulus) and basal segment of base of RV free wall were examined for tissue Doppler study with complete transthoracic echocardiography study.Results - Mean age in group of inferior MI, anterior MI and non Q wave MI are as follows: 61.87±10.7, 57.04±10.7, 58.45±9.2. Sm was significantly reduced in anterior MI groups than non Q wave MI (PV=0.01).In patients with inferior myocardial infarction 88% of patients had left ventricular ejection fraction (LVEF)>45% and in patients with anterior MI 18.2% patients had EF>45%.In non Q wave MI groups 60% patients had LVEF>45%.Conclusion-Except for Sm, other TDI parameters had no significant difference between two groups (transmural and nontransmural infarction) but it has significant changes in reduced left ventricle function and could be of determinants for prognosis.

Background: Classically, one's heart function is mostly based upon its systolic function, whereas the diastolic function steps on second order. In recent years it has been revealed that diastolic function plays an important role in both cardiac mortality and cardiac morbidity. On the other hand is hypertension which due to increasing the afterload, interferes with these functions of heart. In this study we assessed the diastolic function of hypertensive patients using pulse tissue Doppler.Materials and Methods: 30 patients with high blood pressure that had not consumed antihypertensive agents and along with 30 healthy control ones enrolled in our survey, all of whom had normal sinus rhythm without detectable symptoms corresponding to congestive heart failure, ischemia, valvular diseases and pulmonary problems. 2D echocardiography was performed in both groups as well asM Mode and Doppler echo The PTD echo was performed by the lateral annulus of both tricuspid and mitral valves. Systolic and diastolic findings were measured by PTD.Results: Hypertensive patients had negative diastolic findings but no negative systolic ones. PTS illustrated that E/A ratio (early peak velocity / late peak velocity) in right ventricle had significantly decreases (P<0.01) among these patients. In right ventricle, both RT (relaxation time) (P<0.01), DT (decelation time)(P<0.04) and Am (Late Peak Velocity) (P<0.03) were conversely increased. Right ventricular E/A ratio had a significant correlation with that of left ventricl (P<0.005, r =0.5).Conclusion: It seems that hypertension is longitudinally related with diastolic dysfunction of right ventricle. This disturbance would be represented by the lengthened RT and decreasing of E/A ratio which are both resulted from interfering of two ventricle's function and increased pressure of left ventricle. Therefore, PTD can be applied to evaluate the right ventricular diastolic function among patients with high blood pressure.