Ultrasound examination of the brain is not only about conducting. Very important method diagnostics is ultrasound of the vessels of the head and neck or another name for the method. This method involves undergoing an examination without discomfort and finding out the state of the cerebral circulatory system. After such a study, you can find out why there were certain complaints and symptoms of what they were. The advantage of such a method as ultrasound of the vessels of the head and neck is that it allows you to observe in real time how the blood flow works and whether there are risks of serious pathologies (for example, ischemic stroke). Let's take a closer look at what an ultrasound scan of the head and neck area shows, what the principle of this method is and how it is used in practice.

types of ultrasound examination (Dopplerography) of the vessels of the brain and neck

All types of ultrasound of the blood flow of the head and neck are based on the Doppler effect, when the image is obtained by reflecting ultrasound from moving objects (in this case, red blood cells). But this study has its own subspecies, namely:

1. Actually. The method is not very informative and it only allows you to obtain information about the structure of the vessel, while analyzing the state of blood flow to a minimum. The study is carried out blindly, so it is problematic if the patient has a non-standard arrangement of blood vessels. But this method is good if the doctor suspects some vascular abnormalities, but there is no opportunity for a more expensive study (MRI or ultrasound of cerebral vessels with triplex scanning).
2. Doppler ultrasound in duplex mode of paired vessels (or duplex scanning). Here the Doppler works in tandem with a two-dimensional ultrasound sensor. Due to this, information is collected not only about the condition of the vessels, but also about the tissues surrounding them. Duplex scanning is the most successful method for analyzing the vessels of the neck and brain. It gives a complete picture of the state of blood flow in the vessels, as well as their location.
3. Triplex scanning. An improved method that is used if you need to identify various disorders blood flow (turbulent blood flow, reverse outflow of blood, valve pathologies, etc.). Information is obtained by combining duplex scanning and color mapping methods (or color differentiation of velocities in vessels).

Although there are so many research methods, the most commonly used is the standard one. Doppler ultrasound vessels of the brain and neck. It includes a full scan of all vessels entering the cranial cavity.

which shows indications for ultrasound of the vessels of the brain and neck

The method is primarily used in the study of the circulatory system of all those who want to assess their own risk of stroke. But there are categories of people who are clearly indicated for such a study, namely:

• men over 40 years old (in mandatory), as well as women of a similar age;
• patients with diabetes mellitus of any type;
• faces with hypertension second or more stages;
• patients with arrhythmia;
• having osteochondrosis of the cervical spine;
• heavy smokers;
• faces with high cholesterol or low density lipoproteins;
• having congenital or acquired heart disease;
• when planning heart or brain surgery.

You should also know that there is a set of symptoms for which you definitely need to see a doctor and do an ultrasound of the important vessels of the neck and head. These are the following signs:

• dizziness;
• noise in ears;
• unsteady gait;
• insomnia;
• headache;
• deterioration of cognitive abilities;
• visual and hearing impairment.

What does ultrasound of the vessels of the head and neck show:

• artery thickness;
• is the vessel developed correctly?
• are there any foreign inclusions (plaques, blood clots, emboli, inflammatory processes);
• presence of an aneurysm;
• vascular anastomosis;
• most pathologies are in a very early state;
• vasospasm, etc.

By receiving visual information about the presence of a particular pathology, a doctor (neurologist, vascular surgeon, etc.) can assess the degree of its danger and prescribe appropriate treatment. This is very important in assessing and predicting the disease and its possible complications.

How is an ultrasound examination of the neck performed?

When entering the examination room, the patient completely frees his neck, removing possible jewelry, outer clothing and other objects that may interfere with the operation of the sensor. The patient is placed on the couch so that his head is near the doctor and the device with the sensor. The ultrasound specialist first examines the carotid arteries. To take readings from the left artery, you need to turn your head to the right and, accordingly, vice versa. The artery is examined from bottom to top up to the angle lower jaw. During the research, they record at what depth the artery passes, at what height it divides into two vessels - the external and internal artery. Having received necessary information V standard mode, conduct the study in color using color Doppler mode. This allows you to track each section of the carotid artery.

A study in color mode (triplex Doppler sonography) is carried out to record areas where the blood flow differs from normal or the walls of the arteries and veins are greatly modified. As soon as a pathology is discovered, it is carefully examined from all sides and all characteristics are recorded so that the doctor, based on the data obtained, can assess the severity of the disease and the method of its treatment. Having examined one artery completely, they move on to examining another.

No less important is research and vertebral arteries neck. To do this, they use a sensor in a longitudinal projection, taking an image from the side of the cervical vertebrae themselves or between their processes.

How is Doppler ultrasound of the vessels of the head performed?

The advantage of the procedure is that it does not require special preparation. You don’t even have to exclude any food products. The only exception is cigarettes and products containing caffeine (tea, coffee, energy drinks). They affect vascular tone, so they need to be excluded. You should also notify the doctor in advance of all medications you are taking so that he knows which ones can be taken before the procedure.

When the patient comes for the procedure itself, he is placed on his back. To examine transcranial vessels, the sensor is installed on scalp head, which is pre-moistened with gel. Transcranial Dopplerography of cerebral vessels involves a projection image temporal bone, back of the head and above the eye socket. But if you need to obtain information about the vessels before they enter the brain area, the sensor is moved along the neck.

The ultrasound procedure of the head and neck vessels itself does not cause discomfort for the patient. Sometimes you have to stand up, sometimes you have to breathe deeply or, on the contrary, not breathe. The analysis takes place quickly, after which a protocol with the results is immediately filled out.

How to prepare for an ultrasound scan of the head and neck area

Special physical training no need for analysis. What is more important here is the emotional mood. As the patient prepares for an ultrasound of the vessels of the head and neck, this examination will be performed for him. It is especially difficult because it requires perseverance. There is no pain during the analysis, which is also very important. But in order for the results to be as reliable as possible, you should give up vasoconstrictor products (coffee, tea, energy drinks, cigarettes) a couple of days before the test, and also inform your doctor about all the medications you are taking.

Analysis of the results of Doppler ultrasound of the vessels of the head

There are quite a lot of brain vessels being analyzed, therefore, in order not to get confused, it was decided to divide it into segments and assign an alphanumeric symbol to each, depending on the bones of the skull, cartilage of the neck or vertebrae near which the vessel is located. In general, the following indicators are measured:

• artery wall thickness;
• linear blood velocity;
• vessel diameter;
• nature of blood flow;
• presence and degree of artery stenosis;
• pulsation index;
• resistive index;
• systole-diastolic ratio.

Each parameter has its own norm, and the doctor who performed the ultrasound examination of the vessels of the head simply compares the obtained indicators with it. He also monitors the presence of blood clots, atherosclerotic plaques and other formations in the vessels. The results of the study allow us to identify hidden diseases, assess the degree of brain damage, for example, during a stroke, and also help evaluate the effectiveness of therapy.

Interpretation of ultrasound results of neck vessels

It is not enough to obtain visualization of arteries and veins. It is also important to decipher the obtained indicators, and these are:

• blood flow speed during systole and diastole;
• systole-diastolic blood velocity ratio;
• nature of blood flow;
• spectral wave during duplex scanning;
• pulsatory index and resistance index;
• how stenotic the vessel is;
• what is the thickness of the intima-media complex, etc.

As you can see, the indicators are almost identical to those for , which is not surprising, because the same objects are being studied, only in different places their passage.

Norms of ultrasound of the carotid artery

Having received the results of the study, compare them with the norm. For the carotid artery it is as follows:

• the common carotid artery itself departs from the aortic arch on the left, and from the brachiocephalic trunk on the right;
• the characteristics of the spectral wave of the common carotid artery are as follows: diastolic blood flow has the same speed as in both branches of the artery (external - ECA, and internal - ICA);
• there are many extracranial branches in the ECA, but they are normally absent in the ICA;
• in the internal carotid artery the wave should be monophasic, and the blood flow velocity during diastole is higher than in the common artery;
• but in the ESA the wave should be triphasic, and the diastolic blood flow should be very slow;
• the wall thickness of all three vessels should not exceed 1.2 mm.

If any characteristics differ from those indicated normally, atherosclerosis may develop and immediate treatment is required.

Science, including medicine, does not stand still. In diagnostic centers, the price list of services is regularly updated with new methods of deeper, more effective examination of the body. The latest technologies help detect the disease at the earliest stages of its development. For many pathologies, early detection of abnormalities is the key to successful treatment.

Besides the introduction innovative methods research also refines and complements existing ones. Many have come across such an abbreviation as ultrasound.

What is it, what are the principles of operation of this method, and what are the indications for its implementation?

Principle of operation

Ultrasound Dopplerography of blood vessels, also called ultrasound angiography. Essentially, this is a classic ultrasound combined with the Doppler effect (named after the Austrian physicist).

Let us remind you that ultrasound is a study based on the device capturing impulses reflected from the surface of organs and their walls.

If we talk in simple words, then Dopplerography is also based on capturing reflected impulses. Only in this case the impulses are reflected from a moving substance, namely from the formed elements of blood (erythrocytes).

The degree of distortion of the frequency of reflected ultrasonic waves determines the nature of blood flow in the area under study. Doppler ultrasound is a combined study that allows you to see the condition of the walls of blood vessels and the characteristics of blood flow in them.

Ultrasound scanning of vessels is a procedure that does not require any preliminary preparation from the patient, its implementation does not cause discomfort. Doppler ultrasound does not require any intervention in the internal environment of the human body, therefore it has no contraindications and side effects. The study is prescribed to all people age categories, it is carried out like people old age, and newborns.

Ultrasound angiography is performed, usually in ultrasound rooms. The patient lies on the couch. The doctor applies a special conductive gel to the area being examined and, using a sensor that sends ultrasound pulses to different depths, conducts an examination in real time.

The image is displayed on the computer screen. It takes on average from 30 to 60 minutes. After which the patient immediately receives the results, on the basis of which a conclusion is made and a diagnosis is made.

Doppler study involves various techniques. Thus, the blind technique does not include general research Ultrasound, i.e. the area from which the data is obtained is not precisely defined. Today, the B-mode technique is most often used. This study is carried out in duplex mode, and allows you to determine both the location of the vessel, the condition of its walls, and assess the nature of the blood flow through it.

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Research Opportunities

Let's take a closer look at what parameters, indicators and pathologies such a study can show. First of all, vascular ultrasound is prescribed to identify:

Indications for use

The range of diseases and symptoms for which Doppler testing can help identify the cause is quite extensive.

First of all, vascular ultrasound is prescribed for many cardiovascular diseases. vascular system: hypertension, hypotension, headaches unknown etiology, migraine, cardiovascular failure, angina pectoris, atherosclerosis, thrombosis, thrombophlebitis, varicose veins, vascular aneurysm.

And this is far from full list. Vascular Doppler sonography is prescribed for people who have suffered a myocardial infarction and stroke, people suffering from fainting, diabetes mellitus, prolonged and debilitating insomnia, sudden loss of vision or speech impairment, numbness of the limbs, lack of coordination, etc. Dopplerography vascular network placenta is of great diagnostic importance and is recommended by all obstetrician-gynecologists when managing pregnancy.

Most often, Doppler examination of the vessels of the following organs is prescribed:

• Lower limbs;
• Brain;
• Cervical region;
• Placenta and fetus;

Let's take a closer look at the features of each of them.

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Doppler ultrasound of leg vessels

To study the vascular network of the legs, both Doppler examination itself and scanning of vessels in duplex mode are used. Indications for this are: general diseases vascular system, pathology of the vascular apparatus lower limbs, monitoring the dynamics of disease development, monitoring the state of the bloodstream in postoperative period etc.

Ultrasound scanning of the veins of the lower extremities is performed for severe edema, varicose veins, diabetes mellitus, and thrombosis.

Doppler study allows you to determine the extent of damage vascular wall, the condition of the venous valves, make a correct diagnosis and prescribe appropriate treatment.

Doppler test of placenta and fetus

Doppler examination is one of the safest and effective methods studies of the dynamics of intrauterine development of the fetus. As a rule, the first planned ultrasound is performed at 21 weeks.

Doppler test allows you to detect the process premature aging placenta and identify signs of hypoxia in the fetus early stage.

Timely detection of pathological processes makes it possible to prevent delayed physical development of the fetus, fading of pregnancy and miscarriages, both in the early and late stages.

Doppler ultrasound of head and neck vessels

Ultrasound of cerebral vessels (USDG MAG) is performed transcranially, i.e. The vessels located inside the skull are examined. Usually a comprehensive examination of the vessels of the head and neck is performed, because they are closely interconnected.

Ultrasound angiography of the vessels of the head and neck makes it possible to identify atherosclerotic changes in the vessels, narrowing of their lumen or blockage, angiopathy, etc., thereby preventing fatal consequences such as stroke.

Ultrasound scanning of the veins and arteries of the brain is prescribed for people who have suffered a head injury, stroke, or with suspected congenital anomalies structure of the vascular network. People who smoke are also recommended to undergo Doppler examination of the head and neck vessels regularly, once a year. To obtain more accurate results, before examining the vessels of the head and neck, for 24 hours you should avoid consuming products that contain caffeine and increase vascular tone: coffee, cocoa, chocolate, strong tea.

When examining the cervical spine (USDG of the BCA), the condition of paired arteries such as the carotid, subclavian, and vertebral is analyzed. These blood lines also feed the brain, and disruption of their function can lead to adverse effects.

Infants born prematurely, who have suffered intrauterine hypoxia, and with suspected pathologies of the development of the central nervous system are required to undergo an ultrasound scan of the brain and other nervous structures. Such A complex approach is called neurosonography and involves examination of tissues and vessels of the brain and spinal cord. Neurosonography allows us to identify such serious pathologies, such as cysts, tumor formations, abnormalities in the development of tissues and blood vessels, etc. Ultrasound is performed either transcranially, or through the fontanelle, or combining these approaches.

Ultrasound of kidneys

The functional structure of the kidneys is a nephron, a vascular tangle that filters blood and removes toxins and metabolites.

Ultrasound scanning of the veins and arteries of the kidneys is prescribed for injuries, renal failure, thrombotic processes in blood vessels, nephroptosis, tumors. In some cases, with persistent hypertension, the cause of which is not clear, a study of the renal vessels is also performed.

Ultrasound examination of the kidneys requires certain preparatory measures. The optimal period for examination is at least 6 hours after eating. First, for several days, you must adhere to a diet that excludes foods that increase gas formation (carbonated drinks, flour, sweets, Rye bread, cabbage, legumes, mushrooms). It is recommended to take sorbents and preparations based on simethicone.

After fibrogastroscopy and colonoscopy, Doppler examination of the kidneys is not performed due to large quantity gases in the intestinal cavity.

Cost of the procedure

Doppler ultrasound is a relatively inexpensive procedure, considering its capabilities and significance. Thus, in Moscow the price for ultrasound examination of vessels of various parts of the body ranges from 1300 to 5000 rubles, in St. Petersburg - from 1000 to 3000 rubles. Of course, prices vary slightly depending on the clinic offering this service.

Many dangerous diseases on initial stages of their development are asymptomatic, or their symptoms are not convincing enough for a person.

Ultrasound angiography makes it possible to identify a number of such diseases initial stages when it is possible to choose effective treatment and prevent severe consequences for good health.

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Duplex ultrasound scanning, or ultrasound scanning, is a non-invasive, highly accurate diagnostic method based on a combination of Doppler scanning and traditional ultrasound examination. The method allows you to visualize the structure blood vessels, as well as assess the intensity and speed of blood flow.

Duplex scanning is ultrasound or Dopplerography

Traditional ultrasound diagnostics uses ultrasonic waves that are not perceived by the human ear. When interacting with internal organs, the waves are reflected and captured by a special ultrasonic sensor. The intensity of reflection of ultrasonic waves depends on the density of the organ being examined and its structure. After the sensor catches the reflected ultrasonic waves, the computer processes them and converts them into a black-and-white two-dimensional image.

With duplex scanning, traditional ultrasound is complemented by Doppler ultrasound, a study based on measuring the reflection of ultrasonic waves from moving objects.

A beam of ultrasound waves is reflected from red blood cells moving with the blood flow and is assessed by a special sensor, and the speed of reflection depends on the speed of blood movement. Thus, adding Doppler scanning to a regular ultrasound makes it possible to evaluate not only the structure of the tissue being examined, but also the direction, speed and intensity of blood flow within it. The movement of blood is reflected on the monitor in the form of red-blue flashes, the intensity and direction of which are assessed by a diagnostician.

Ultrasound duplex scanning: indications for examination

Ultrasound examination in combination with Doppler sonography is widely used in medical practice due to its painlessness and simplicity. The disadvantage of such research is that the equipment is quite expensive; not all medical institutions can afford it.

Ultrasound scanning allows you to reliably evaluate such indicators as:

• intensity and speed of vascular blood flow;
• vascular wall thickness;
• the presence of blood clots or plaques in the lumen of blood vessels;
• the structure of the vessel, its width, length, degree of tortuosity.

The quality of the results obtained during the study directly depends on the quality of the equipment and the qualifications of the diagnostician. Ultrasound scanning is performed to diagnose the following pathologies:

• occlusion of the carotid arteries;
• atherosclerosis of the lower extremities;
• thrombosis and thromboembolism of any location;
• arterial aneurysms;
• aortic diseases;
• atherosclerosis of the coronary arteries;
• varicose veins;
• Raynaud's disease;
• cerebral circulatory disorders.

Preparation for ultrasound examination

Duplex ultrasound scanning does not require any special preparation from the patient, the only exception being ultrasound scanning of the abdominal vessels (abdominal aorta).

Ultrasound scanning of the abdominal aorta requires additional preparation, including:

1. bowel cleansing with an enema;
2. fast for 8 hours.

Preparation measures are related to the physical characteristics of the passage of ultrasound waves, which are not able to pass through intestinal gases.

Ultrasonic duplex scanning technique

Ultrasound scanning is non-invasive and painless method research that has no contraindications. To carry out the procedure, the patient is placed on a special couch with the head end elevated. The doctor applies a special gel to the ultrasound sensor and begins examining the required vascular area with sliding movements.

After obtaining a clear picture of the structure of the organ under study using traditional ultrasound, the diagnostician switches to Doppler ultrasound mode, which allows assessing vascular blood flow. The monitor of the device for ultrasonic scanning displays the information received from the sensor in the form black and white pictures with colored flashes, it is the colored flashes that reflect the movement of blood through the vessels.

Duplex scanning of the veins of the lower extremities

Ultrasound scanning of the veins of the lower extremities is one of the most precise methods assessment of the state of the venous bed, allowing:

1. assess the venous structure and patency of the veins;
2. identify excessive narrowing or expansion of venous vessels;
3. establish the presence of venous thrombosis or atherosclerotic plaques;
4. measure the speed and intensity of venous blood flow;
5. assess the condition of valves in the venous bed;
6. monitor the dynamics of the treatment.

Doppler scanning of the veins of the lower extremities allows us to detect the appearance of vascular pathology in the early stages, when clinical manifestations no illness yet. Thanks to early detection blood flow disorders, treatment begins in the early stages, which minimizes adverse consequences for the patient.

Regular conduct of this study is indicated for all people over 40 years of age. It is mandatory to prescribe an ultrasound scan of the veins for:

• swelling and pain in the legs;
• increased vascular pressure;
• diabetes mellitus;
• visible varicose veins;
• smoking;
• obesity;
• non-healing sores and discoloration skin lower extremities.

The results of the study are assessed by a phlebologist, surgeon or therapist.

Duplex scanning of head and neck vessels

Duplex scanning of extracranial (neck vessels) and intracranial (head vessels) arteries and veins is used to assess disorders cerebral circulation. Widespread this study to assess the condition of large cerebral and carotid arteries. The method allows:

1. assess the speed of vascular blood flow in the arteries and veins of the neck and head;
2. determine the presence of atherosclerotic formations and the degree of their influence on the blood supply to the brain;
3. assess the risk of developing vascular complications (ischemic attacks, strokes);
4. identify vascular aneurysms and arterial narrowings;
5. assess the hemodynamics of the brain;
6. assess the reserve capacity of cerebral circulation;
7. identify disturbances in venous outflow.

An objective assessment of the condition of the arteries and veins of the brain and necks, obtained using a duplex study, helps to select the correct treatment, monitor its effectiveness and create an individual prognosis for recovery. Ultrasound scanning of the vessels of the head and neck is indicated for the following conditions:

• headache;
• dizziness and heaviness in the head;
• noise in ears;
• periodic loss of consciousness;
• changes in gait and loss of coordination;
• memory loss;
• visual impairment;
• numbness and weakness of the hands.

An examination of the vessels of the neck can be prescribed by a neurologist in case of pathology of the cervical spine, to assess the degree of impairment of vascular blood flow. You can read more about methods for examining cerebral vessels.

Duplex scanning of the brachiocephalic arteries

Brachycephalic arteries, or BCA, are vessels of the neck and subclavian region that provide nutrition to the brain, namely vertebral, carotid, subclavian arteries. Duplex scanning of the brachycephalic arteries allows one to assess the intensity of blood supply to the brain, as well as identify the presence of atherosclerotic lesions.

Most often, duplex scanning of the BCA is used specifically for diagnosing atherosclerosis and objectively assessing the size of the atherosclerotic plaque.

Ultrasound scanning makes it possible to detect atherosclerosis of the brachycephalic arteries in the early stages, at the stage of thickening of the arterial wall and long before the appearance of a full-fledged atherosclerotic plaque. Thickening of the walls of the BCA is assessed by the thickness of the intima-media complex, and or IMT. An increase in this indicator even by one millimeter above the norm is an unfavorable criterion for the development of atherosclerosis.

Duplex BCA examination is indicated for patients with the following symptoms:

• dizziness, headache, noise in the head;
• high blood pressure;
• deterioration of visual acuity;
• memory loss;
• sensations of goosebumps and numbness in the hands.

It is mandatory to perform ultrasound scanning of the brachiocephalic arteries in patients with spinal osteochondrosis localized in cervical spine, as well as patients with coronary artery disease or diabetes mellitus.

Ultrasound diagnostics(ultrasound) of blood vessels: how and when to do it, advantages, special situations

Vascular diseases have become a real plague of our time. Scientists believe that blood vessels have changed little during evolution, but people’s lifestyle has changed dramatically: physical inactivity, eating refined foods, polluted environment, information overload. All this negatively affects the condition of human organs, including blood vessels. However, medicine is also not asleep - it is developing. Its arsenal contains a fairly impressive collection of methods for treating vascular pathologies. The most effective and safest are Doppler studies.

Today, to study the state of blood vessels and blood flow, it is most often used Doppler ultrasound (USDG) And duplex scanning of blood vessels (DS).

What are the advantages of these techniques?

• They are highly informative.
• Allows you to identify the earliest preclinical signs vascular diseases, assess vascular lesions and blood flow disturbances.
• They are non-invasive and absolutely safe.

Doppler techniques are so named because they are based on the same Doppler effect (after the name of the Austrian physicist). The essence of the phenomenon is the reflection of an ultrasonic beam from moving objects, for example, blood cells. This changes the frequency of the signal. These changes help determine the speed of blood flow, the direction of blood movement, atherosclerotic stenosis, volumetric minute blood flow, vessel blockage, assess collateral circulation, and the presence of pulsation. All these indicators are determined using ultrasound.

Doppler ultrasound as an isolated study is used less and less today. Mostly, DS is used - duplex scanning, which combines Doppler ultrasound and traditional ultrasound. Traditional ultrasound (B-mode) informs the physician about vascular anatomy through two-dimensional images in black and white. The use of this mode complements Doppler ultrasound with a graphic image or areas, assessing the characteristics of changes in vascular patency, conducting a study of the size and density of the blood clot, and studying the condition and diameter of the vessel wall. If there are fistulas, their size is examined. A more accurate determination of the location of the damaged vessel is possible.

A healthy (left) and stenotic (right) artery in a duplex ultrasound image.
In the first case, the blood flow has a normal course, speed (about 60 cm/s) and color
In the second, the blood flow is impaired; due to the narrowing of the artery, its speed in the affected area reaches 507 cm/s

Other options for Doppler sonography are not fundamentally different from those described above. Eg, color mapping translates information about blood flow into more convenient form: deoxygenated blood color on the monitor Blue colour, and arterial – in red.

Triplex scanning is a technological mode of DS. It is not an independent ultrasound technique. During this study ultrasound machine operates in three modes: B-mode, Doppler ultrasound and color Doppler mapping mode.

Important! The determining factor when choosing a research option should not be the price, but the doctor’s recommendation. Depending on the location of the vessels and the nature of the lesion, one or another research method is prescribed.

Video: a doctor explains the principles of ultrasound diagnostics of blood vessels

Doppler studies of the vessels of the lower extremities

To conduct a study of the vessels of the lower extremities, two options are used: the actual ultrasound of the vessels of the lower extremities and duplex scanning. These procedures reveal such ailments as arterial thrombosis, and others.

The main goals of studying the blood vessels of the legs:

1. Diagnostics ;
2. Detection of aneurysm;
3. Assessment of the condition of peripheral vessels;
4. Diagnosis of pulsating formations;
5. Observation of dynamics;
6. Definition ;
7. Diagnosis;
8. Preoperative marking of veins.

We can safely say that ultrasound techniques are the most advanced methods for examining the vessels of the legs. For example, using duplex scanning of the veins of the lower extremities, you can study the vessels in detail, determine the degree of change in them, and make the correct diagnosis. It is important that these methods reveal vascular disorders at a very early stage, which cannot always be done in other ways.

When to see a doctor?

Signs of pathology arteries:

• The feeling is often noted;
• There are complaints of weakness in the limbs;
• They arise for an unknown reason;
• There may be pain when running, walking;
• The legs become cold to the touch and pale as the temperature in them decreases;
• The person limps, although there are no inflammatory processes in the joints.

On problems with veins indicate:

1. , worse in the evening;
2. Brownish skin of legs;
3. Occurrence;
4. Long-term non-healing ulcers may appear;
5. Become noticeable.

It should be noted that numbness, weakness, convulsions and other signs may appear in completely healthy people. Therefore, there is no need to immediately diagnose yourself and, even worse, prescribe treatment. Contact your doctor, tell us about your suspicions, and if necessary, you will be prescribed an examination and only then treatment.

Advantages of ultrasound examination of leg vessels:

• Absolute safety;
• Painless;
• Information content;
• Non-invasive (no damage to the skin);
• Speed ​​of manipulation (the patient receives the result immediately);
• Can be done at any age;
• Low price.

Ultrasound of the blood vessels of the legs is performed on an outpatient basis. After applying a special gel, the doctor uses a sensor to examine the vessels. Pathological changes clearly visible on the device monitor. With color mapping, it is easy to distinguish veins from arteries. The entire manipulation lasts less than an hour. There is also no need to prepare for the examination.

Important! The conclusion of Doppler ultrasound of the vessels of the lower extremities is not yet a diagnosis. The degree of pathology is determined only by the attending physician.

Video: doctor about ultrasound of leg veins

Ultrasound examinations of blood vessels during pregnancy

This is the most safe way obtain information about the child's condition. Dopplerography of the fetus helps to trace the dynamics of intrauterine development. Already during pregnancy at 21 weeks future mom and her attending physician receive extensive information about blood flow in the uterus, placenta and fetus, pressure in the vessels, and their elasticity. Thanks to this study, you can find out about the lack of nutrition of the fetus, about possible pathology in development.

Degrees of change in fetal blood flow:

1. Changes in the blood flow of the uterus and placenta.
2. Disturbance in the blood flow of the fetus and placenta.
3. Non-critical changes in the blood flow of the fetus, uterus and placenta.
4. A critical change in the blood flow of the fetus, uterus and placenta.

If mild degrees of changes in blood flow are detected, the pregnant woman should be examined weekly. If the condition worsens, you need to be examined every day. With this pathology, natural delivery at term is possible.

If the second degree of pathology is diagnosed, it is recommended to be examined every other day. If necessary, after 32 weeks a caesarean section is performed.

If the third degree of pathology is detected, then monitoring should be carried out daily.

Doppler examination of pregnant women is carried out unscheduled in the following cases:

• Multiple pregnancy;
• Fluctuations in blood pressure;
• Abnormal fetal size;
• Delays in child development;
• Disturbances in the condition of the placenta;
• Diabetes mellitus in the mother.

Video: Ultrasound during pregnancy

Ultrasound of cerebral vessels

This examination is called differently transcranial dopplerography . Essentially, this is a duplex scan of the blood vessels of the brain. The term "transcranial" means that the examination is carried out inside the skull. Usually performed in conjunction with duplex scanning great vessels neck and head (BCA).

The worst thing that can happen to the blood vessels in the brain is their blockage. As a result, necrosis occurs. This state is called. Some people recover well after a stroke, others - alas. It all depends on the location of the damaged vessel and the degree of brain damage.

Happens, of course. acute disorders blood flow But more often the first “bells” appear long before the sad event. They manifest themselves with certain symptoms (which are discussed below), but they can also be asymptomatic. It is important to notice these “bells”. After all, many people do not consider insomnia or memory impairment to be a symptom. Very rare, but congenital ones do occur. However, more often they make themselves felt at a young age.

To assess the state of cerebral blood flow, it is enough to perform a transcranial Doppler ultrasound procedure.

Transcranial Doppler ultrasound informs the doctor and patient about:

1. The condition of the internal choroid;
2. Damage to the vascular wall;
3. Elasticity of blood vessels;
4. The presence of formations inside the vessels;
5. Changes in vascular anatomy.

What can be revealed?

• (inflammation of vascular walls and their changes);
• Anomalies in the location or course of blood vessels;
• Traumatic lesions;
• Angiopathy (toxic, diabetic, hypertensive);

By performing a Doppler study of the vessels of the head, you can understand:

1. Degree pathological process resulting in damage to arterial vessels;
2. Causes of strokes;
3. The degree of change in the lumen of blood vessels due to diabetes mellitus, atherosclerosis, smoking.

The results of ultrasound scanning of the vessels of the head and neck allow the doctor to assess the condition of intracranial and peripheral vessels and prescribe correct treatment and make an individual forecast.

Indications for Doppler examination of the vessels of the head

After reading scary stories about the consequences of violation cerebral blood supply, many come to the conclusion that it is urgently necessary to be examined. There is a category of people who explore the length and breadth of their body, but, as a rule, find nothing. But nerves and money were wasted. Is it necessary to do this?

Some may argue that everyone, without exception, should undergo a study of cerebral vessels, even healthy ones. There are also congenital anomalies of vascular development. What if it suddenly appears, which also suddenly explodes and kills its owner? So, go ahead and get examined!

We can console the alarmists: congenital vascular anomalies are very rare. And another thing: a person can have a lot of asymptomatic diseases. Does this mean that all sorts of ultrasounds and the like should be done? Trust the opinion of a specialist, describe your complaints to him, and he will decide whether to examine your brain or not.

Doppler examination of the vessels of the head may be prescribed in the following cases:

• Dizziness;
• Presence of signs;
• Heaviness in the head;
• Fainting;
• Tinnitus;
• Deterioration of vision;
• Movement coordination disorders;
• Weakness in the legs or arms;
• Speech disorders;
• "Goosebumps" in your hands.

Sometimes a person undergoes other types of examinations (MRI, scintigraphy, CT), as a result of which disorders are detected. To clarify the diagnosis, the doctor prescribes Doppler ultrasound.

Planned Dopplerography

1. Elderly people whose relatives suffered from vascular diseases;
2. Patients with diabetes mellitus;
3. Experienced smokers;
4. People with rhythm disturbances;
5. Having metabolic syndrome;
6. Patients who have had a stroke;
7. People with ;
8. Patients after surgical intervention in the brain or spinal cord or awaiting surgery.

Preparing for the examination

No special preparation is required to conduct a head examination. The only thing: on the day of the study it is not recommended to consume foods that affect vascular tone:

• Coffee;
• Energetic drinks.

It is advisable to refrain from smoking.

Concerning medicines, which can affect the results of the study, it is not recommended to cancel them without the permission of the neurologist.

Study details

Transcranial Dopplerography is carried out according to the same principle as other Doppler techniques. Ultrasound beams penetrate the brain vessels through the skull.

The doctor alternately brings the sensor to various areas heads:

1. Supraorbital;
2. Temporal;
3. Nape area;
4. Place of transition spinal column into the occipital bone.

A special gel is first applied to the areas to be examined, which provides best contact sensor with skin.

In addition to examining the blood vessels, the doctor does functional tests(for example, a request to hold your breath) to clarify or refute the diagnosis of a violation of autonomic regulation.

What does the examination indicate about pathologies?

• ABOUT vasculitis judged by changes in the echogenicity of the vessel, vascular wall, differentiation of wall layers.
• Non-stenotic atherosclerosis it can be suspected if the thickness of the vessel wall is increased, but the artery is narrowed by no more than 20%. The echogenicity is changed in an uneven manner.
• Hypoechoic formations with a thin rim - this is how they are diagnosed plaques in the arteries.
• Requires mandatory treatment narrowing of the artery by 50% or more.

Video: doctor about ultrasound of head vessels

Carrying out examination of cerebral vessels for children

A young child is more likely to undergo a comprehensive brain scan called neurosonography . To be more precise, this term combines different techniques studying the state of the central nervous system: examination of the spinal column, brain and spinal cord, blood vessels, head tissues. But it is customary to call neurosonography an ultrasound examination of the brain.

By using ultrasonic techniques the doctor can identify tissue pathologies, diagnose intracranial increased pressure and other disorders.

Today, neurosonography is performed in three different ways:

1. The simplest one is transfontanelle. The name speaks for itself: the sensor is brought to the child’s fontanel and the brain is examined. The disadvantage is that the study of the brain is done in one projection.
2. The second is transcranial neurosonography. It requires more serious equipment. The brain of adults is also studied in this way.
3. The third method combines the other two. Transcranial-transfontanelle neurosonography is performed on young patients. Advantages – the brain is viewed in different projections. Requires more time to carry out and serious equipment.

Main indications for the study:

• Prematurity;
• Suspicions of CNS pathology;
• Inflammatory diseases of the central nervous system.

No special preparation is needed for the examination. The procedure is absolutely safe and painless.

Study of the brachiocephalic arteries (main vessels of the neck)

The brain is nourished not only by intracranial, but also by peripheral vessels. Important role belongs in process brachiocephalic arteries (brachiocephalic trunk, carotid artery, subclavian and vertebral arteries). Atherosclerotic changes in them can become a serious problem. If plaques appear in the arterial vessels that feed the skin, bone, and muscle tissue, there will be no big trouble. The brain is a completely different matter. Several are responsible for its blood supply large vessels− arteries. A blockage in any of them can eventually lead to a stroke.

The most common complaint of people with BCA pathology is dizziness. It mainly appears when you turn your head sharply. Sometimes - as a result of low blood pressure. Of course, one-time dizziness is not a problem. It can occur due to overwork, change atmospheric pressure or for other reasons, but relapses of this condition cannot be discounted.

BCA research is carried out in the following cases:

• Frequent headaches for unknown reasons;
• When manifested clinical signs stroke or ;
• The patient has diseases that provoke cerebral circulatory disorders (vasculitis, diabetes, arterial hypertension and others);
• Clinical signs of BCA;
• The presence of pathology of surrounding tissues (if there is a possibility of compression of the BCA).
• Upcoming operations on the heart and blood vessels.

Diagnostics

Typically, to make a diagnosis, BCA is examined using a test, which determines the characteristics of the blood flow.

To clarify the diagnosis, duplex scanning of the brachiocephalic arteries is used. The doctor can visually assess any deficiencies in the anatomy of the arterial vessels. This undoubtedly increases diagnostic capabilities. Using this technique, the doctor determines deformities, blood clots, plaques and other pathological changes.

Video: doctor about ultrasound of the BCA

Ultrasound examination of renal vessels

Ultrasound scanning of renal vessels is performed to obtain Additional information about renal blood flow. This study is more informative compared to conventional ultrasound. Interstitial blood flow and vessels of the renal pedicle are studied.

When is a Doppler ultrasound examination of the kidneys prescribed?

• In humans for a long time arterial hypertension of unknown origin is diagnosed.
• A routine ultrasound revealed a difference in the size of both kidneys.
• There are signs of renal failure.
• Traumatic kidney damage.
• There are suspicions of thrombosis.
• A disturbance in the movement of blood in the kidneys is predicted. (More often this situation is observed with vascular anomalies, tumors, atherosclerosis, thrombophlebitis, nephroptosis).

Is preparation necessary?

You need to properly prepare for Doppler ultrasound of the kidneys. Moreover, the success of the study is directly related to the level of training. Excess intestinal gas may invalidate the test result. That's why preparation should begin several days before the procedure. From your diet you need to exclude fruits, legumes, sauerkraut, carbonated drinks, sweets, fruit juices, rye bread. It is useful to take enterosorbents.

It is advisable to conduct the examination on an empty stomach in the morning. If ultrasound examination is performed in the afternoon, you can have a small snack in the morning. The main thing is that at least 6 hours pass from eating to the procedure.

Important! Dopplerography of renal vessels cannot be performed after diagnostic examinations such as fibrogastroscopy and colonoscopy. This is due to the large amount of air entering the intestines as a result of these procedures.

There is no doubt that timely diagnosis vascular diseases is extremely necessary. Thanks to her, she manages to help many people live not only a long, but (which is important) an active life. Therefore, the advantages of Dopplerography and duplex scanning as the main methods are indisputable early diagnosis. Paying attention to your body is the key to maintaining health.

Video: a neurologist performs Dopplerography (using the example of cerebral vessels)

Ultrasound is one of the safest and most promising directions diagnostics of internal and surgical diseases. Its diagnostic importance as a method lies not only in its penetrating ability, but also in its ability to view tissue in cross-section, similar to tomographic methods. A relatively new type of ultrasound examination is Doppler scanning of blood vessels, which greatly expands the capabilities of modern non-invasive diagnostics.

Doppler testing involves determining the frequency of the returning sound. From the piezocrystal, waves of a certain frequency are sent to the projection area of ​​cerebral vessels, the blood in which reflects this sound.

In addition, the reflected sound, due to the presence of a certain speed in the blood, is reflected from it with a changed frequency, which is recorded. This change allows us to judge the speed of blood flow in a given area of ​​the vessel. So, walking along the length of the vessel, you can find a narrowing or, conversely, an expansion.

In addition, special stress tests are used to determine the performance of anastomoses, the importance of which lies in compensating the blood flow of a certain area when the lumen of the artery that brings blood here or the vein that drains blood is blocked. Such functional tests have no analogues. Doppler examination is very indicative and greatly facilitates the diagnosis of diseases, including topical ones.

How is Doppler vascular examination performed?

What is being examined?

During Doppler sonography, a specialist uses a sensor to examine the vessels of the brain or neck above their projection. In the neck area, the carotid and vertebral arteries are examined, jugular veins(internal external and anterior) and venous vertebral plexus, subclavian arteries and veins.

Of the cerebral vessels, the external and internal carotid arteries, basilar, posterior, middle and anterior cerebral arteries, cerebral arteries, connecting arteries (circle of Velisius arteriosus), and veins are subject to examination.

The vessels of the brain take part in the formation of the so-called circle of velisium, which is an anastomosis connecting the blood supply of the right and left halves big brain. Can also be used to study blood flow in the brain more small arteries: supratrochlear, orbital.

The procedure itself

Often a neurologist will refer you for such an examination. During the examination, the patient sits with his head tilted to the side, or lies with a cushion under his neck.

Special stress tests are used to investigate possible functional disturbances in hemodynamics. The patient is asked to turn his head to the sides, cough, hold his breath, and one of the common carotid arteries is compressed.

When you cough, your blood pressure begins to rise. chest cavity, therefore, blood from the veins of the neck and head does not pass to the right atrium, which can cause neurological symptoms, such as headaches. Using Doppler examination, the degree of slowing of blood flow is assessed. The same thing happens when you hold your breath.

When the carotid artery is clamped on one side, the area of ​​the circle of velisium (the base of the brain) is examined with a sensor. The direction of blood flow in the anterior communicating artery is assessed (anastomosis between the anterior cerebral arteries different sides cerebrum), which indicates the consistency of the roundabout circulation. The procedures are carried out quite briefly so as not to disrupt the blood circulation of the brain. Also, Doppler examination of the vessels of the head and neck can be performed after taking nitroglycerin, which dilates blood vessels.

For transcranial examination of blood vessels, points are used where bone represented in smaller numbers: the temporal region, suboccipital (access to the cerebral arteries and veins) and orbital (the study is carried out through the supratrochlear and orbital arteries to the internal carotid artery).

Why is this research being done?

Doppler examination of cerebral vessels is one of the most the best ways monitoring the state of blood supply to this area. This non-invasive and completely painless method allows you to solve two problems at once, understand the cause of the headache that the patient is complaining about and at the same time relieve the attending physician from headaches.

– duplex scanning – allows you not only to examine the vessel (its structure, wall, surface, lumen, the presence of deposits on the intima), but also, using a scale, to trace the dynamics of blood supply and blood movement through these vessels. This not only makes it possible to detect pathology, but also to make a prognosis about the future disease, and to assess how great the risk of ischemic stroke is for a given blood flow.

Displaying duplex scan results

The first thing a doctor pays attention to when prescribing this examination method is the patient’s complaints:

• headache
• dizziness
• ringing or noise in the ears,
• disturbance of the sensory and motor innervation of the skin and muscles of the head, respectively
• complaints about “flickering flies”
• visual impairment, including partial and transient

Doppler scanning allows you to see the anatomy of the vessels of the head and neck, the state of their lumen, wall thickness, and visualize organic disorders, assessing the circulatory disturbances created by this pathology allows us to identify the disease itself (stenosis, lumen occlusion, atherosclerotic plaques, compression, etc.) without using methods that penetrate into the human body directly.

Purposes of duplex examination of cerebral vessels

• early diagnosis of vascular diseases
• detection of narrowing or compression of cerebral vessels
• detection of defects in the development of blood vessels, which are congenital and may not manifest themselves in any way before examination
• functional assessment of the adaptation of the brain to a given type of vascular development or current condition
• detection of difficulties in the flow of blood from the intracranial cavity through the veins
• detection of local changes in the arteries of the brain and neck associated with any systemic disease(atherosclerosis, etc.)
• dynamic assessment of the condition of blood vessels and the brain during treatment or in connection with the disease

Indications for Doppler examination of blood vessels

Indications for the procedure for examining the vessels of the brain and neck are various disorders of the central nervous system. nervous system, possible reason which is vascular pathology, namely:

• relevant complaints (head pain, visual impairment, hearing impairment, persistent memory problems and others)
• diabetes
• hypercholesterolemia (including a shift in the lipoprotein index towards low-density lipoproteins)
• some transferred acute diseases(coronary heart disease (myocardial infarction, post-infarction cardiosclerosis, arrhythmias), stroke)
• endocarditis
• thrombophilia
• stenosis or compression of neck vessels
• vegetative-vascular dystonia

Ultrasound signs of main pathologies

Why are these particular indications singled out for this procedure?

Atherosclerosis

Conditions such as arterial hypertension and hypercholesterolemia are a risk of developing atherosclerosis, including the vessels supplying the brain. Atherosclerotic plaques, firstly, themselves block the lumen of the artery, and secondly, they can rupture and serve as a site for the formation of blood clots.

The first will be the reason chronic ischemia brain and, as a result, disorders of memory, mental activity, etc.

Second is dangerous acute condition, such as thromboembolism or simply complete closure of a cerebral vessel in place, which will cause the development of cerebral infarction - stroke.

The condition after a stroke is an indication for monitoring the condition of the wall of the vessel that caused the disease.

Thrombosis and thromboembolism

Conditions after a myocardial infarction (post-infarction cardiosclerosis, cardiac aneurysm), cardiomyopathy, endocarditis, arrhythmias can lead to the formation of blood clots. Blood clots in the heart are the cause of thromboembolism for any organ. Good blood supply to the brain can lead to blockage of its vessels. Therefore, vascular Doppler in people who have suffered such diseases is quite important.

Thrombophilia is a condition of increased blood clotting. In such cases, again, many small blood clots appear in the vascular bed, which can serve as emboli and block the vessels of the brain. DIC syndrome(disseminated intravascular coagulation), also manifested by increased thrombus formation, which occurs when severe course infectious processes, pregnancy complications and others. When neurological symptoms appear or increase, people suffering from this pathology are recommended to undergo Doppler vascular examination.

Violation of tissue trophism

Diabetes mellitus is very dangerous because its main target is small vessels, including those of the brain. Sugar (glucose) begins to accumulate in the wall of the vessel and it thickens. As a result, the transmission of oxygen and nutrients from the blood to tissues is disrupted, and nervous tissue is very sensitive to starvation, more than others.

Compression of blood vessels

Compression of blood vessels can cause neurological symptoms, which the patient will complain about. Compression of the arteries can lead to cerebral ischemia, dizziness, headaches, and loss of consciousness. Impaired blood flow from the brain through the vessels of the neck will lead to headaches due to increased pressure on the dura mater.

Conclusion

Doppler of the vessels of the brain and neck is now widely used in medical practice and is used for many indications. It allows you to differentiate many pathological conditions, including acute ones, in a non-invasive way.

It is very important that Doppler examination makes it possible to assess the state of blood supply in dynamics and observe functional deviations in the functioning of the cardiovascular system, which is so important for human life.