Scanning of neck vessels. Duplex scanning of head and neck vessels (BCA): what it shows and when it is prescribed, the pros and cons of the study. Why should it be done in our clinic?

Diagnostics

High precision equipment
Modern research methods

Duplex scanning vessels

Prices for Duplex scanning of blood vessels

Ultrasound examination of blood vessels- duplex (triplex) scanning with color Doppler flow coding.

The method is safe, painless, highly informative, combines visualization of vessels and tissues surrounding the vessel with simultaneous examination of blood flow in the lumen of the vessel to identify the presence of blood clots, atherosclerotic plaques and assess the degree of narrowing of the arteries, aneurysms (vasodilatation), pathological tortuosity blood vessels, disturbances in the blood supply to vital organs. Allows you to reliably evaluate all existing changes vascular wall, including on early stages vascular diseases.

Why should it be done in our clinic?

Vascular examinations are carried out in our clinic highly qualified specialists who examine almost all parts of the vascular system, who have extensive experience in examining patients with vascular diseases, including surgical patients who have undergone reconstructive surgery on the arteries of the extremities, vessels of the head and abdominal cavity. If necessary, during research they are used additional methods, such as compression and rotation tests, Valsalva test, Allen test, test with reactive hyperemia, etc. Active cooperation of specialists with doctors clinical departments will allow you to receive the necessary consultations based on the results of the examination.

Indications

Cerebrovascular disease ( headache, dizziness), osteochondrosis cervical spine spine, arterial hypertension and hypercholesterolemia

Varicose veins, thrombophlebitis, phlebothrombosis, postthrombophlebitis disease

Atherosclerosis, endarteritis and diabetic angiopathy arteries of the lower extremities

Atherosclerosis of visceral branches abdominal aorta(vessels supplying organs gastrointestinal tract and kidneys)

Aneurysm of the abdominal aorta and other vessels

Vascular injuries and their consequences

Vascular monitoring before surgery

Vascular control after surgery

Screening examination (a study to identify asymptomatic forms of the disease)

A specialist - a vascular surgeon (angiosurgeon), cardiologist, neurologist, therapist - will help you determine which vessels need to be examined.

Contraindications

This research method has no contraindications.

Methods and indications:

Duplex scanning of brachiocephalic arteries and cerebral vessels

The study is carried out to identify the causes of headaches, dizziness, in the presence of spinal pathology, arterial hypertension, with elevated blood cholesterol levels, to identify pathological tortuosity and variations in the structure of blood vessels supplying the brain, and also as a screening for early detection atherosclerosis. The examination begins with an examination of the vessels at the extracranial level (brachiocephalic arteries at the neck level), and, if necessary, an examination at the intracranial level (cerebral vessels).

To conduct the study, the patient must undress in the office from the waist up (down to underwear), remove jewelry from the neck and lie on the couch on his back with his chin raised. Depending on the complexity of the case, the examination can take up to 30–40 minutes.

Preparation

Duplex scanning of the venous system (veins of the lower extremities, veins of the upper extremities).

The study is carried out to diagnose varicose veins, thrombosis of deep and saphenous veins, identify the causes of swelling and pain in the extremities, for patients who have previously undergone venous thrombosis for dynamic observation, also as a preoperative preparation.

To conduct the study, the patient must undress in the office below or above the waist (down to underwear), remove socks, stockings, bandages (if any) and lie on the couch on his back. In some cases, the study is also carried out with the patient standing and lying on his stomach; at the doctor’s request, simple tests are performed (breath holding, straining). Depending on the complexity of the case, the examination can take up to 30–40 minutes.

Preparation

The study does not require special preparation for the patient.

Duplex scanning of the venous system (inferior vena cava, iliac veins, renal veins)

Examination of the veins at the abdominal level is performed on patients to determine the level of spread of thrombosis, if any, and to monitor the installed vena cava filter.

Preparation

Duplex scanning of the arterial system (arteries of the lower extremities, arteries of the upper extremities)

The study is carried out on patients to identify the causes of pain in the limbs that occur during movement and walking, to clarify the degree and extent of narrowing of the arteries during atherosclerosis, patients with diabetes mellitus, and control of patients who have undergone reconstructive surgery on the arteries of the limbs.

Preparation

The study does not require special preparation for the patient.

Duplex scanning of the abdominal aorta, iliac arteries, visceral branches of the abdominal aorta (celiac trunk, superior mesenteric artery, renal arteries)

The study is performed on patients to clarify the reasons pain syndrome in the abdominal cavity, which may be caused by stenosis (narrowing) or occlusion (blockage) of the branches of the abdominal aorta (for example, the mouth of the celiac trunk) or an aneurysm (enlargement) of the abdominal aorta, as well as to exclude narrowing renal arteries with arterial hypertension.

To conduct the study, the patient must undress in the office from the waist up (down to underwear), lower his trousers or skirt and lie down on the couch on his back. Depending on the complexity of the case, the examination can take up to 30–40 minutes.

Preparation

The study is carried out in the morning, on an empty stomach.

1. Three days before the test, exclude gas-forming foods from the diet: vegetables, fruits, legumes, dairy products, brown bread.

2. Last appointment food the day before 19-00 o'clock.

3. If the patient is prone to constipation, it is recommended to perform a cleansing enema the night before.

4. On the eve of the study, take 2 capsules of espumisan after each meal (3-4 times a day

Duplex scanning of the complex: left renal vein, spermatic vein, veins of the pampiniform plexus

The study is carried out as part of an examination for infertility, in the presence of dilated veins of the scrotum (varicocele).

To conduct the study, the patient must undress in the office from the waist up (down to underwear), lower his trousers and underwear and lie down on the couch on his back. During the examination, at the doctor’s request, simple tests are performed: holding your breath, straining. Depending on the complexity of the case, the examination can take up to 30–50 minutes.

Preparation

The study is carried out in the morning, on an empty stomach.

Three days before the test, exclude gas-forming foods from the diet: vegetables, fruits, legumes, dairy products, brown bread.
2. Last meal the day before 7:00 p.m.
3. If the patient is prone to constipation, it is recommended to perform a cleansing enema the night before.
4. On the eve of the study, take 2 capsules of espumisan after each meal (3-4 times a day

Duplex scanning of blood vessels, rectus muscles of the eye

To conduct the study, the patient lies on the couch on his back and closes his eyes.

Preparation

The study does not require special preparation for the patient.

Duplex scanning of arteriovenous fistula

The study is carried out for patients preparing for the application of an arteriovenous fistula for hemodialysis sessions, as well as for monitoring functioning fistulas.

To conduct the study, the patient lies on the couch on his back, freeing the arm being examined.

Preparation

The study does not require special preparation for the patient.

Duplex scanning of the internal mammary arteries

The study is carried out as part of preoperative preparation for patients preparing for surgery - coronary artery bypass surgery for inspection of arteries as material for shunts.

To conduct the study, the patient needs to undress from the waist down in the office and lie on the couch on his back.

Preparation

The study does not require special preparation for the patient.

Ultrasound of head and neck vessels ? modern method diagnostics of blood flow in the vessels that supply blood to the brain. Ultrasound examination makes it possible to accurately assess the state of patency of extracranial vessels (extra cranial, vertebral and carotid arteries), and vessels that penetrate brain tissue (three types of arteries: anterior, middle, posterior).

It should be noted that the ultrasound procedure will not provide a complete image of the condition of the vessel and determine the ability to identify key factors of vascular obstruction. Ailments such as thrombosis, stenosis, spasms, and the formation of atherosclerotic plaques require additional procedures for examining the vascular system in the neck and head.

Indications for ultrasound of the brain and neck

people who have problems with cerebral circulation (acute or chronic);
patients who have suffered vascular injuries due to traumatic brain injury and neurosurgery);
after toxic vascular damage;
after diagnosing asymmetry or absence of pulse, blood pressure in the area upper limbs(hands);
with a pronounced murmur on the aortic arch;
with sudden loss of vision;
various range of pathologies of the cervical spine (after diagnosing osteochondrosis, injuries, congenital anomalies, poor posture) if there is a threat of compression of the vertebral artery and impaired blood supply to the spinal cord.

Ultrasound of brain and neck vessels, price which is optimal for patients of different financial capabilities - it is advisable to repeat the available ultrasound screening procedure from time to time for re-examination of patients with atherosclerosis and other pathologies of the blood vessels of the head. The risk group for vascular diseases of the brain includes people with bad habits (tobacco smoking), overweight, and those suffering from hypertensive and ischemic heart disease.

Ultrasound diagnostics allows early detection of disturbances in blood flow to brain tissue. Oxygen starvation of tissues leads to worsening of the condition. A timely ultrasound will help prevent a cerebral stroke. Ultrasound screening is recommended for monitoring patients suffering from vascular pathologies and comparing the results of the condition of blood vessels after a course of treatment.

Ultrasound is provided to a specialist important information about the patency of arterial vessels that are responsible for feeding the brain - the value of the data obtained is immeasurable. The doctor will be able to quickly identify disturbances in the outflow of blood from the cranial cavity, which can have fatal consequences. Based on the diagnostic results, the neurologist determines the degree of development of collateral and venous pathology. Ultrasound shows the branching of the vascular system, evidence of the presence of arteriovenous malformation and impaired vascular patency. The information obtained is important for the subsequent selection of effective therapy.

Preparing the patient for ultrasound of the vessels of the head and neck

Despite the fact that ultrasound of the vessels of the brain and neck is an affordable procedure, the patient needs to take into account some nuances for maximum accuracy of the result.

On the day of the procedure, it is advisable for the patient to:

interrupt the reception medicines or limit them if the appointment cannot be canceled due to the presence of other diseases;
avoid drinking tea or coffee (caffeinated drinks);
refrain from smoking cigarettes for two hours before the procedure.

It is important to adhere to these rules to avoid increased vascular tone.

To ensure accurate results, it is advisable to remove jewelry from the head and neck area.

Method of performing ultrasound of the vessels of the head and neck

In the office near the device there is always a comfortable couch for the client to relax. The procedure should not cause discomfort or pain. The ultrasound specialist places the device's sensor on the patient's skin to direct ultrasound into the area of passage blood vessels requiring diagnostics.

If there is insufficient blood flow in the vessel, the Doppler effect will not be displayed on the device screen. Computer processing of digital data allows you to evaluate the graph of blood movement through the vessel in real time. Ultrasound of the vessels of the brain and neck often includes additional functional tests:

hyperventilation;
finger pressure;
finger pressure;

This helps to more accurately diagnose the mechanism of blood flow regulation.

For severely ill patients, the extended Doppler ultrasound procedure is used - ultrasound signals are converted into sound signals. After listening to the data, the specialist is able to accurately assess blood flow in the area of the neck or head being examined. This will allow you to quickly identify a blockage or narrowing of a vessel, and determine the degree of disruption of blood transportation through the circulatory system.

The time for ultrasound diagnostics ranges from 30-45 minutes. Portable Dopplerography takes three times less time.

Contraindications to the ultrasound procedure of the vessels of the head and neck

There are no age restrictions for ultrasound. Ultrasonic waves are absolutely safe for humans. During long-term treatment vascular diseases, the procedure can be used several times in a row.

The procedure may be difficult to implement if the diseased vessel is covered with bone tissue or a large layer subcutaneous fat. Difficulties in performing diagnostics using ultrasound waves arise in patients with arrhythmia and cardiac pathologies, in patients with slow blood flow.

The procedure cannot be carried out on areas of damaged skin - this makes it impossible to attach the device’s sensor. It is advisable to wait for healing and only then do an ultrasound.

Types of ultrasound

Exist different types Ultrasound procedures of head and neck vessels:

ultrasonography soft tissue
ultrasound examination of the skin
ultrasound examination of lymph nodes
ultrasound examination of the salivary glands
ultrasound examination of the pleural cavity
echocardiography
duplex scanning of the aorta
duplex scanning of the brachiocephalic arteries with color Doppler mapping of blood flow
duplex scanning of thyroid vessels and ultrasound examination of the thyroid gland and parathyroid glands.

Devices for ultrasound diagnostics is now available in every clinic and medical center, and therefore this type of examination is available to many patients.

Characteristic

Ultrasound examination of cerebral vessels is one of the most common today. It is based on the reflection of an ultrasonic wave from the area under study. It is used to detect anatomical pathologies of the vertebral, basilar, carotid arteries, anterior and internal jugular veins, subclavian artery and veins, facial vein. Ultrasound of cerebral vessels shows the diameter of the lumen, internal formations, and the condition of surrounding tissues.

The procedure, supplemented by Doppler ultrasound, allows you to detect areas of blood vessels with impaired blood flow due to their narrowing, blockage, and neoplasms. With its help, the functioning of the circuitous blood flow pathways is checked, the treatment being carried out and the results of the surgical intervention are monitored.

Today, when giving a referral for ultrasound diagnostics, a doctor separately indicates the type of examination: ultrasound, Doppler, duplex, triplex or transcranial. In most cases, a simple ultrasound is not performed, but is combined with Doppler ultrasound in order to obtain a complete anatomical and functional picture.

The advantages of ultrasound diagnostics include safety, non-invasiveness, painlessness, good quality information received, breadth of use, low price. It is also important that the study does not require administering a contrast agent or irradiating the patient. In addition, ultrasound imaging provides a picture in real time.

The study also has disadvantages: it can be used to easily find out about the condition large vessels, but small branches may be hidden behind the bones of the skull. This prevents us from getting the full picture. The deposition of calcium salts during atherosclerosis also interferes with obtaining accurate information. Difficulties also arise when carrying out the procedure in obese people. When conducting transcranial triplex scanning of cerebral vessels, the quality of the information received may deteriorate due to the specifics of the equipment.

Indications

Ultrasound is scheduled and performed on a regular basis for people over 40 years of age, patients leading a sedentary lifestyle, prone to severe emotional stress, depression and often experiencing stress. Regular examination is important both for those who have undergone surgery and those who are suspected or have already been diagnosed with the following diseases:

problems with blood circulation in the brain;
traumatic brain injuries;
cervical osteochondrosis;
arterial hypertension;
diabetes;
neoplasms in the head or cervical spine;
past diseases associated with inflammatory processes;
atherosclerosis.

Indications for ultrasound diagnostics are the appearance of disorders such as constant headaches, dizziness, darkening of the eyes, tinnitus, weakness, tingling, numbness in the arms and legs. Other important reasons include: loss of consciousness, which happened even once, disturbances in speech, vision and hearing, attention, performance, and memory. An ultrasound is required before surgery on the brain or heart.

Dopplerography

This study performs only one function - determining the speed of blood flow and its direction. A graph with the results of the study appears on the monitor. There is no visualization of blood vessels.

Direct Dopplerography of the brain allows you to obtain the following information about the vessels:

elasticity of walls;
characteristics internal cavity;
violation of the integrity of the walls;
formations inside the lumen;
change of course;
branch of a branch in the wrong place.

Duplex scanning of cerebral vessels is an ultrasound examination that combines a two-dimensional picture - the anatomical structure of the vessels, the tissues around them and the speed of blood flow. Using this method, they find atherosclerotic plaques, blood clots in arteries and veins, and check the condition and integrity of the vascular wall.

There are extracranial studies, aimed at checking the main highways, and scanning, studying the intracranial vessels located in the skull. During the procedure, the common carotid arteries are examined along their entire length, the internal carotid arteries up to the entrance to the skull, and partially the external carotid and vertebral arteries.

Duplex scanning of the vessels of the head and neck makes it possible to diagnose the disease at an early stage of development.

Triplex scanning

The results of intracranial and extracranial triplex scanning of arteries and veins of the brain reflect them anatomical structure. The blood flow is presented in color depending on the speed in a particular area. Depending on the subject of study - veins or arteries, the image is colored blue or red.

This is not a separate research method, but an extended duplex scanning of cerebral vessels with additional function. The vessels are viewed in two longitudinal and one transverse planes.

Transcranial

Transcranial Dopplerography of cerebral vessels is a type of duplex study. Its main purpose is to study the speed and direction of blood flow in intracranial vessels. The goal is to identify hematomas, large lesions and control previously detected disorders. It is impossible to examine the walls of the vessels located in the skull. Information about the structure and lumen of the artery is available only in color mode, the change of which depends on the speed of blood flow.

With transcranial duplex scanning, brain vessels can be seen in two planes.

TCD of cerebral vessels is indicated in the following cases:

Indirect signs of damage to the arteries in the skull were found.
Symptoms of cerebral ischemia, the causes of which are unknown, have been identified.
A duplex scan of cerebral vessels showed signs of stenosis and blockage.
Constant headaches.
The patient has a difficult vascular disease, leading to impaired cerebral circulation.
With brain pathology, which leads to vascular deformation and impaired blood flow.

Read also on the topic

The most common cerebrovascular diseases: clinical symptoms and treatment

TKDS is performed only after duplex. The sensor is located on the temple, back of the head or eye socket.

Separate view An ultrasound examination aimed at checking pathologies of the newborn’s brain is neurosonography. IN Lately in many maternity hospitals, this examination is carried out even before the baby is discharged, and a pediatrician or neurologist prescribes it when the baby reaches 1 month or according to indications.

It is mandatory to carry out it if the child was born prematurely, at birth received an Apgar score of less than 7/7 points, there are suspicions of hydrocephalus, cerebral palsy, malformations or developmental delays, intrauterine infections, genetic pathologies or diseases of the nervous system.

Another group of indications for neurosonography are prolonged or, conversely, quick birth, birth injuries, Rhesus conflict and tracking the dynamics of the baby’s treatment.

Currently there are 4 types of research:

Transfontanel NSG is performed through the large fontanel. This technique provides a complete examination of the brain cavity, and therefore is the most common. However, it is carried out only up to a year - by this time the fontanel usually closes. The most informative examination is immediately at birth or during the first few months.
When performing transcranial USG, data is obtained through the temporal, and sometimes parietal bones.
The combined method includes examination through the fontanel and bones cranium.
USG is also performed through bone defects.

There is no need to prepare your child for the examination. The procedure is performed without anesthesia and sedatives.

NSG allows us to establish signs of increased intracranial pressure. An increase in the size of the ventricles of the brain indicates the accumulation of cerebrospinal fluid and the development of hydrocephalus. The detected focus of ischemia indicates probable oxygen starvation. Detection of hemorrhage is an indication for urgent hospitalization.

During the examination, various cysts may be found. Subependymal cysts look like fluid-filled cavities and are located near the ventricles of the brain. Such formations require treatment. Appear due to lack of oxygen or hemorrhage.

Vascular cysts look like small bubbles with fluid, located at the site of cerebrospinal fluid secretion. Formed during childbirth or in the prenatal period. Usually do not require treatment.

Arachnoid cysts occur as a result of infections, hemorrhage, trauma, and can be located in any part of the head. Their rapid growth leads to compression of nearby tissues. Treatment is necessary.

Signs of some diseases diagnosed in infancy can be detected in the perinatal period. During pregnancy, 3 ultrasound examinations are performed, each of which reveals signs of brain pathology.

First trimester screening is performed at 12-14 weeks. It allows you to detect acrania, anencephaly, exencephaly, cranial hernia, as well as signs of certain chromosomal pathologies, such as Down syndrome.

In acrania, there are no bones of the skull. Anencephaly is characterized by the absence of not only the bones of the skull, but also the brain. For exencephaly bone tissue no, but brain tissue is partially present. A cranial hernia is diagnosed when fragments protrude through defects in bone tissue meninges.

During screening in the second trimester, features of the formation of the brain and face are checked. By this time, all anatomical structures and organs have been formed. Much attention is paid to the head circumference and its shape, calculated as the ratio of the biparietal and fronto-occipital dimensions. A lemon-shaped, strawberry-shaped shape is determined. Look at the size of the head - small or disproportionately large. Are measured lateral ventricles. Their increase indicates hydrocephalus.

The study of the cerebellum is of particular importance - the size of the hemispheres and the degree of development of the cerebellar vermis are determined. Its underdevelopment leads to an inability to maintain balance, muscle inconsistency, abruptness of movements, and trembling of the limbs. The visual thalamus, corpus callosum, horns of the lateral ventricles and many other areas of the brain are studied.

Attention is also paid to the facial skeleton. Often the shape of the nose and cleft lip are a symptom of chromosomal diseases.

The purpose of the third screening is to confirm or exclude defects detected in the first two studies. At the same time, CTG is performed - registration and analysis of the fetal heart rate. This study shows signs oxygen starvation, which can have Negative influence on brain development.

How to prepare for a brain ultrasound

Ultrasound of cerebral vessels is usually prescribed by a neurologist or therapist. When receiving a referral, it is necessary to discuss the use of vasoconstrictors or vasodilators with a specialist. Your doctor will probably ask you to stop taking them temporarily.

The day before the procedure, it is recommended to exclude from the diet foods that can affect the tone of the walls: alcohol, pickles, caffeine-containing drinks and foods, including coffee, tea, chocolate, energy drinks. Drinks with ginger and ginseng are also contraindicated.

You should have your last meal 4-5 hours before the examination. It is not recommended to take it two hours before the ultrasound. hot bath. There is also no need to smoke - smoking a cigarette leads to a narrowing of the arteries and veins.

Immediately before the procedure, you need to remove all jewelry from your head and neck and tie your hair in a ponytail. To examine the cervical region, it will need to be freed from clothing.

Carrying out an ultrasound

The examination is carried out in a special room. The patient is placed on the couch so that the head is located next to the ultrasound machine. A gel or special ointment is applied to the sensor location to improve contact with the skin. Ultrasound waves pass through a blood vessel and are reflected from it in different ways. The difference in reflection depends on the speed and volume of blood flow. The reflected waves are converted into electrical impulses and transmitted to the monitor screen.

Today, duplex ultrasound scanning (USDS) is the most informative diagnostic method in identifying pathologies of cerebral vessels.

During the procedure, it is possible to determine their anatomical structure, the presence pathological processes, as well as real-time blood flow status.

Duplex scanning combines several simultaneously various techniques– Ultrasound (ultrasound examination) and Doppler ultrasonography.

What is ultrasonic scanning: the essence of the method, modes

Translated from English word Duplex means double. In this case, the use of two ultrasound modes is implied:

B – mode – the essence of the method is that the sensor emits ultrasonic waves of a certain frequency passing through the patient’s tissues. Then, at different densities of the tissues being examined, ultrasound is reflected and the signal returns back to the sensor. The device emits ultrasonic waves and receives a return, reflected signal in a pulse mode, that is, at different time intervals. For example, if it is necessary to examine the most distant areas (of an echogenic structure), much more time passes between the ultrasound radiation and the reflection of the signal than when diagnosing structures located closer to the device. Unique properties sensors allow you to emit waves under different angle, with different time intervals. Modern technology allows you to scan and visualize a two-dimensional image of the vessels of the brain and neck vessels in a matter of minutes.
Doppler - this technique is based on the Doppler effect: ultrasound directed at the area under study, when colliding with a moving object, not only sends a response signal, but also changes the frequency and, accordingly, the wavelength of the radiation. When diagnosing blood vessels, the main object from which ultrasound is reflected are red blood cells. This allows you to identify the exact spectrum of blood flow speed.

Also using innovative method Color Doppler scanning (CDC) allows you to build a color cartogram of blood flow in the vessel under study.

What does ultrasound scan show?

Duplex scanning of the vessels of the brain and neck allows you to study in detail their structure, condition and direction of blood flow. Each of the above modes determines the following data about the vessels of the head:

Ultrasound examination (B-mode) determines the location of blood vessels in the human body, their diameter, and the condition of the vascular lumen is assessed; the technique allows us to identify various pathologies that interfere with normal blood flow (for example, blood clots formed on the walls, cholesterol plaques); The most innovative devices are capable of visualizing a layer-by-layer image of the vessel.
The Doppler mode allows you to study in detail the hemodynamics of blood movement through the vessels, the direction of blood flow, and its speed.

Duplex scanning of the vessels of the head is a procedure that allows you to fully study almost all parameters of the blood vessels and make the most accurate diagnosis.

The technique is universal when it is necessary to identify pathological processes in the vessels of the brain and neck. In addition, the study refers to non-invasive diagnostic methods, which suggests it complete safety and the ability to carry out ultrasound examination the required number of times.

During the diagnosis, not only blood vessels are visualized, but also nearby tissue structures. Intracranial duplex scanning is used to study the cerebral vascular beds. If it is necessary to obtain a color image, transcranial duplex scanning is used.

In what cases is a study prescribed?

Duplex ultrasound scanning is used for various diseases and pathological conditions cerebral vessels:

congenital vascular malformations;
deformations of head vessels;
atherosclerosis;
injuries;
when blood clots form in the vessels of the brain (thrombosis);
if you suspect the presence of an aneurysm (expansion of part of the vascular wall);
inflammation of blood vessels (vasculitis);
damage to blood vessels (angiopathy);
with discirculatory encephalopathy (brain damage that occurs due to circulatory failure);
in the presence of diseases in nearby adjacent tissues and structures.

Diagnostic measures are also prescribed for patients who have the following symptoms:

migraine;
constant feeling of heaviness in the head, accompanied by tinnitus and
frequent headaches;
dizziness;
motor coordination disorders, unsteadiness when walking;
fainting;
feeling of weakness and numbness in the legs and arms;
speaking disorders.

Duplex scanning is prescribed to patients who have had a stroke in the past or surgical intervention on the vessels of the brain, as well as people suffering from chronic cerebrovascular accidents. In this way, the condition of blood vessels and blood flow is monitored. Duplex scanning most informatively identifies secondary pathological changes vessels of the head if present various diseases(for example, with a persistent increase in blood pressure or in the presence of diabetes mellitus).

The study is prescribed in the presence of large tumors inside the brain (cystic, cancerous formations and hematomas). In this case, the goal of diagnosis is to evaluate the tumor and its blood supply. Ultrasound scanning is also required before surgical intervention on cerebral vessels or to determine methods of conservative treatment.

Duplex scanning is of high importance in neurological practice and makes it possible to diagnose cerebral circulatory disorders in the early stages of development. This allows you to take timely measures to prevent acute process. In this case, the possibility of detailed research is of great importance cholesterol plaques, their density.

At-risk groups

Duplex scanning is prescribed to people who are predisposed to developing diseases of the vascular system. The following categories of patients are at risk:

long-term smokers;
people who are overweight;
people leading a sedentary lifestyle, which as a result leads to physical inactivity;
exposed to frequent stressful situations;
age category after 45 years;
patients with a history of diabetes mellitus of any stage;
in the presence of higher level cholesterol in the body.

Preparing for Duplex Scanning

No special preparation is required for the ultrasound duplex scanning procedure. Diagnosis is carried out at any time of the day, but more often in the morning.

If the patient takes such medications, like Phezam, Betaserc and some others, you need to consult with your doctor about taking them on the day of the procedure.

Immediately before the examination, all possible jewelry should be removed from the head and neck area. At the end of the procedure, you should thoroughly wash your head and neck to completely remove any remaining gel.

Features of the event

Since ultrasound is a non-invasive diagnostic method, it does not cause pain or discomfort, and therefore does not require the use of anesthesia. The procedure is performed in a sitting or lying position, depending on which area of the head is being examined.

Then the specialist applies skin of the examined area is a transparent gel, which acts as a conductor between human body and an ultrasound sensor. The sensor is installed on the required area of the head; more often, certain areas with the thinnest bones of the skull are used for this purpose. Thus, ultrasonic waves freely penetrate inside the skull.

The duration of the diagnosis takes between 20-30 minutes, during which the specialist may ask the patient to hold his breath or change his body position. The procedure is well tolerated and does not cause discomfort.

Contraindications

Duplex scanning is completely safe procedure, which is used in patients of different ages, in particular in children, to diagnose diseases of the vascular system. The examination has no contraindications.

Duplex scanning is not performed in seriously ill patients who are unable to take the necessary body position for diagnosis.

Interpretation of ultrasound results

After a duplex scan, the doctor has complete information about the condition of the blood vessels in the brain. The examination results contain a small amount of digital data and determine the anatomical features of the vessels, their patency, hemodynamics, as well as the presence of various pathological formations inside the vessel that impede normal blood flow.

To make a final diagnosis, the doctor compares the results with normal indicators. Based on these values, a final diagnosis is made.

Duplex scanning (USD) is a non-invasive and safe examination of the cervical vessels that supply blood to the brain. The technique allows us to identify the anatomical features of vascular highways, the quality of blood flow in them, and accurately and quickly track the development of thrombotic and atherosclerotic changes in vessels at an early stage.

Duplex scanning of the vessels of the head and neck is modern techniques studies using ultrasound of brachycephalic vessels - large venous and arterial lines that supply blood to the brain, head and hands. These vessels separate from the aorta in the shoulder area.

Duplex scanning offers an improved approach that has replaced Doppler ultrasound. In fact, the study combines Dopplerography (studying the properties of blood flow) and B-mode - the ability to “see” on the monitor the condition of the vascular walls and adjacent tissues.

The procedure makes it possible to identify:

Scanning makes it possible to evaluate:

elasticity of vascular walls;
blood flow level;
quality of regulation of vascular tone - peripheral and central;
functional reserves of the cerebral blood supply system.

Using ultrasound, you can diagnose:

Availability anatomical features or anomalies;
atherosclerosis – detection of atherosclerotic plaques of the brachycephalic arteries is one of the main objectives of the procedure;
traumatic damage to venous or arterial lines;
inflammation of the walls - large vessels (arteries) or small ones (capillaries);
angiopathy (disturbances in the structure of capillaries, up to significant narrowing or blockage) - diabetic, hypertensive or toxic in nature;
discirculatory encephalopathy - brain damage against the background of a slowly developing cerebrovascular accident;
vegetative-vascular dystonia is a complex of symptoms (cardiac, respiratory, temperature disorders), the cause of which is a failure of the nervous system.

Kinds

Brachycephalic vessels are a set of intracranial (vascular highways located inside the cranium) and extracranial (vessels located outside the skull - in the neck, face and back of the head, but also involved in feeding the brain).

Based on this principle, UZDS are distinguished:

extracranial sections of the vessels of the head and neck - assessment of the condition of the common carotid arteries and their branches, brachiocephalic and vertebral vessels. As a rule, this type of procedure becomes a priority, since it is the extracranial sections that most often contain atherosclerotic changes;
intracranial(transcranial) sections of the vessels of the head and neck - scanning of arteries and veins located inside the skull (circle of Wellis and cerebral arteries). It is recommended in situations where the first type of study did not produce results, and symptoms of impaired cerebral circulation are present. The examination has a number of features, one of which is related to the fact that a special ultrasonic wave frequency is used - 2 MHz - such ultrasound is able to penetrate the bones of the skull. In addition, the sensor must be applied to the so-called “ultrasonic windows” - areas of the skull where the bones are thinner;
combination first and second varieties.

Intracranial examination can be carried out in isolation from the first one - if the purpose of diagnosis is control after surgical manipulations on intracranial vessels.

Duplex scanning of the vessels of the head and neck can be performed:

as planned– in the presence of specific, but not life-threatening symptoms that prompt a person to contact a diagnostic specialist;
urgently– when the patient is in a serious or acute condition.

Differences between duplex and triplex scanning

Both studies are advanced Doppler ultrasound. Both triplex and duplex should be distinguished from ultrasound Dopplerography. Ultrasound scanning does not visualize the vessel; all information is provided in the form of graphs. The curves can only indicate blood flow abnormalities and suggest the cause (thrombus, narrowing, rupture).

In addition, during ultrasound examination, the sensor is applied in a “blind” manner, approximately in those places where the vessels should be projected.

Duplex and triplex involve visualization - like any ultrasound examination. Looking at the monitor, a diagnostic specialist can track the position of the sensor and visually assess the vessel and the movement of blood in it.

The differences are presented in the table:

Type of study	Duplex scanning	Triplex scanning
What is being studied (functions)	Vessels are assessed according to two (duplex) criteria - structure and level of blood flow.	“Duplex” functions are performed - visualization of the structure and assessment of blood flow. A third (triplex) option is added to “see” the movement of blood through the vessel in color mode and more accurately diagnose obstructions.
Resulting image	Flat black and white	The movement of blood in the veins and arteries is shown in color (the picture is a combination of color and black and white). This makes it possible to more accurately and easily monitor wall thickness abnormalities or the presence of obstructions to blood flow.
Price	Cheaper	Expensive

From a diagnostic point of view, the main advantage of the triplex is greater visibility, which is important given that the assessment occurs only at the moment the sensor is applied. However, the information content of the procedures differs slightly - the accuracy of diagnosis is largely influenced by the quality of the equipment used and the experience of the medical specialist.

Indications for the study

Duplex scanning of the vessels of the head and neck is performed when characteristic symptoms or the presence of confirmed diagnoses, the person’s belonging to a “risk group”.

The procedure is also indispensable for choosing adequate treatment and monitoring the condition for the following confirmed diagnoses:

vascular endarteritis ( inflammatory process, developing in the tissues of the vascular wall and accompanied by their narrowing);
atherosclerosis – deposition of cholesterol and complex proteins in the lumen of vascular highways;
traumatic damage to blood vessels;
Aortic aneurysm - expansion of the area main artery against the background of weakening of the tone of its wall;
thrombosis and thrombophlebitis - the occurrence of blood clots inside a vessel, including those accompanied by inflammation;
vasculitis - inflammation of blood vessels of an autoimmune nature, when functional cells are attacked by their own the immune system person;
diabetes mellitus or diabetic angiopathy (changes in the structure and functioning of blood vessels as a complication of metabolic disorders);
injuries or osteochondrosis of the cervical spine;
the presence of varicose veins;
hypertonic disease;
vascular malformations – the presence of congenital abnormal connections between vessels;
vegetative-vascular dystonia;
post-infarction and post-stroke periods;
preparation for surgical manipulations on the heart;
rehabilitation period after surgical interventions on the vessels of the head and neck, brain or spinal cord.

For example:

Pros and cons of the method

Duplex scanning of the vessels of the head and neck is significantly more informative than Doppler ultrasound.

Other advantages and disadvantages of the procedures are presented in the table:

Procedure evaluation criterion	Explanation of the criterion for ultrasonic inspection	Advantages and disadvantages
Information content	High	+
Conduction speed	The study takes up to 40 minutes	+
Safety	The procedure can be performed for any condition of the patient	+
Presence of contraindications	Information content may be reduced in the presence of calcified deposits	+
Painfulness and invasiveness	Absent, the procedure can be carried out repeatedly (unlike an X-ray examination, for example). Ultrasound scanning does not cause any complications	+
Need for special training	No specialized preparatory procedures are required	+
Possibility of recording results on media	It is not possible to print out a visual image; the vessels are assessed only during ultrasound scanning, “here and now”	—
Dependence on the human factor and technical equipment	Significant	—
Price	The examination is more expensive compared to Doppler ultrasound	—
Availability	The procedure requires modern equipment and qualified personnel - ultrasound scanning is carried out by large or private clinics	—

How to prepare

Duplex scanning of the state of the vessels of the head and neck requires minimal preparatory measures - it is enough to limit the consumption of drinks and drugs that affect blood circulation and vascular tone.

If the patient is taking medications that affect vascular tone or reduce blood pressure, it is necessary to check with the doctor in advance which of them should be discontinued.

How is the procedure performed?

The principle of the procedure is the same for Doppler ultrasound, duplex and triplex. Before starting the study, the patient will need to remove jewelry and hairpins from his head and neck.

If there is a need for intracranial (intracranial) examination, the gel will be applied to the following areas:

left and right temple;
area above the eye sockets;
the place where the back of the head connects to the spinal column;
occipital region.

The procedure is completely painless, takes from 20 to 40 minutes, after which you will need to remove any remaining gel from the skin and hair.

Decoding the results

As a rule, results can be obtained within a few minutes after ultrasound scanning. The result is a printout containing a list of examined vessels with a description, and the presence of anatomical anomalies is also reflected there.

The description of the condition of the artery includes the following indicators:

the nature of blood flow;
the speed of blood movement along the artery – maximum (max) systolic (during contraction of the heart muscle) and minimum (min) diastolic (at the moment of relaxation):
pulsatory index - calculated based on the maximum and minimum blood flow speed;
resistive index - also calculated based on speed indicators;
the ratio of speeds in systole and diastole - maximum divided by minimum;
wall thickness, artery diameter.

Pulsator and resistive indices, as well as the max/min ratio are measured to assess arterial patency.

Normal values vary for different arteries.

Index	Common carotid artery	External branch of the carotid artery	Internal branch of the carotid artery	Vertebral arteries
Diameter, mm	4–7	3–6	3–6,5	2–4,5
Speed in systole (max), cm/sec	50–105	35–105	33–100	20–60
Velocity in diastole (min), cm/sec	9–36	6–25	9–35	5–25
Resistive index	0,6–0,9	0,5–0,9	0,5–0,9	0,5–0,8

Normally, the artery should not contain narrowings (0% stenosis), thickening or plaque, and blood should move freely without flow turbulence (eddies).

Common deviations from normal vascular characteristics include:

stenosis– the lumen is narrowed, blood is not able to flow freely;
aneurysm– local expansion of the vessel wall against the background of a weakening of its tone;
atherosclerotic changes– the lumen of the vessel is narrowed due to the presence of cholesterol plaques. The conclusion describes the structure, size, degree of narrowing;
turbulent blood flow– the presence of turbulence in the blood flow;
disturbance of vascular tone with vegetative-vascular dystonia;
vasculitis– a thickened wall over a long period of time or a delaminating wall.

Ultrasound scanning of veins contains fewer digital indicators; here it is assessed:

anatomy and tortuosity;
patency and quality of outflow;
diameter and presence of obstacles in the lumen of the vein.

Are there any contraindications

Vascular duplex is safe, there is no discomfort during the procedure, and there is no negative effect on the body. There are no age or other restrictions for conducting the survey. The results can be distorted by the presence of atherosclerotic deposits with high level calcification - a process when calcium salts settle on top of a cholesterol plaque.

Where to undergo the procedure

Duplex scanning of head and neck vessels is available in large public or private clinics, as well as commercial medical institutions who specialize in diagnostics.

The cost of the procedure in Russia varies from 800 rubles. (if only intracranial or only extracranial vessels are scanned) or 1200 rub. (for combined ultrasonic inspection) in remote areas of the country, up to 2000–5000 rubles. in large cities.

The price consists of a combination of the following factors:

clinic location;
scope of the study (number of veins and arteries assessed, need for functional tests);
qualifications and category of specialist diagnostician, titles and academic degrees;
quality of equipment.

Duplex scanning of the condition of the vessels of the neck and head is a modern non-invasive procedure that allows, in 40 minutes, to obtain comprehensive data on the condition of the arterial and venous lines and veins that ensure the functioning of the brain.

The combination of ultrasound with Doppler sonography is an invaluable technique for the timely diagnosis of atherosclerosis and vascular stenosis. Preventive examinations for people at risk help reduce the likelihood of developing acute disorders cerebral circulation.

Article format: Lozinsky Oleg

Video about duplex scanning of blood vessels

What is this procedure and what is it used for: