Duplex scanning of vessels - Causes, Symptoms and Treatment .MF .
Preparing and conducting
Nowadays medicine offers quite a wide range of instrumental diagnostic methods to accurately confirm or deny the existence of a definite diagnosis of the patient.One is the duplex scanning of vessels - vascular examination method, which is based on the use of the Doppler effect by means of ultrasound.Ultrasound
not absorbed by the body soft tissue (muscle, vessel wall, the internal organs), and reflected from them, and using the digital devices displayed on the monitor device in the form of two-dimensional image.In the case of the study of structures with moving liquid media (in this case vessels) ultrasound is not only reflected from moving blood cells, but even changes its frequency depending on the speed of the elements that is recorded on a computer screen and gives an indication of blood flow velocity.This is called the Doppler effect.
Thus, duplex scanning of vessels - is an instrumental method for diagn
Such an image of the vessel sees the doctor on the monitor
unit The advantages of this method is the non-invasive (no introduction in the tissues of the body), the lack of radiation exposure, accessibility (in modern hospitals is good equipment necessary equipment), the ability to accurately diagnose existingvascular pathology.
Indications for duplex scanning of vessels
This method is applied when the doctor suspects that the following disease states:
- anomalies or vascular strain, creating an obstacle to the normal blood supply to organs,
- atherosclerosis of the aorta and its branches,
- atherosclerosis of the lower limbs,
- thrombosis of the veins and arteries,
- varicose veins,
- endarteritis and vasculitis (inflammation of the vascular wall),
- diabetes and its complications (diabetic angiopathy of retinal vessels, arteries of legs and feet - "diabetic foot syndrome"),
- arterial hypertension (in conjunction with the impairment of brain functions - circulatory encephalopathy),
- aortic aneurysm,
- heart disease (eg, aortic valve regurgitation, which leads to disruption of blood flow in the blood vessels supplying the brain),
- pathologyvessels of the brain in newborns.
When surveyed possible diagnosis of diseases of the following groups of vessels:
1. blood brachiocephalic Assessment (brachiocephalic) artery - rendered common, external and internal carotid arteries.
survey is necessary if the patient complains of a certain character:
- frequent headaches, migraines,
- fall with loss of consciousness or without,
- "noise" in the ears, flashing "flies" before the eyes,
- transient ischemic attacks
- frequent dizziness
2. Assessment of transcranial blood flow (intracranial) vessels - anterior, middle and posterior cerebral arteries:
- held in conjunction with the scanning of brachiocephalic arteries.
3. Diagnostics arterial disease and venous limbs necessary in case of symptoms such as:
- the presence of vascular "stars" on their feet,
- varices of the lower extremities,
- marked swelling of the lower extremities, worse when walking,
-pain, fatigue in the arms or legs,
- coldness of extremities,
- syndrome, intermittent claudication - for example, people who smoke a large number of cigarettes for a long period of time, formed resistant vascular spasm, leading to disruption of blood supply to the legs and feet muscles,
- changes in skin color (blue, violet color) combined with significant pain sensations may testify in favor of an acute venous or arterial thrombosis.
4. diagnosis of diseases of the aorta and its branches :
- ascending aneurysm, thoracic and abdominal aorta.
5. diagnosis of renal vascular diseases, liver, thyroid, prostate, eyeball :
- tumor relevant authorities to assess the degree of vascularization (proliferation of vasculature) in them,
- cirrhosis of the liver, portal vein thrombosis with the assessment of intrahepatic blood flow,
- chronic renal insufficiency, glomerulonephritis,
-. diabetes with damage to retinal vessels, leading to blindness, injury of the eyeball, etc.
Contraindications for research
Just as for a standard ultrasound, for duplex scanningarteries and veins absolute contraindications exist.It is probable technical difficulties when ultrasound can "reach" the test vessel, such as a high degree of obesity in a patient in the study of liver vascular and kidney injuries open skull fractures, the orbit, the extremities, the presence of extensive wound surfaces on the skin in the projectioninvestigated vessels.
Preparing for a patient to duplex scanning of arteries
The special training is not necessary.The patient can observe the usual routine and take the usual amount of food and water.
How is the research?
for duplex scanning of arteries, you must have ultrasound scanner software (hardware, the ability to perceive the reflected ultrasonic beams, register them as graphic curves and converted into two-dimensional image with color flow mapping) and an ultrasonic sensor.
patient can be delivered to the office of ultrasonic diagnostics in a planned or emergency basis.Routinely it is sent from the clinic or hospital department profile, where there is an inpatient at the moment, and for emergency indications carried out a survey of persons with suspected acute thrombosis, ischemic stroke, aneurysm of the aorta and other acute vascular diseases.
After the patient give birth to the office, he laid on the couch and asked to release on the clothes of the body under study.Next, the doctor applied to the skin gel - a guide for a better "grip" from the sensor wheel and better patency of the ultrasonic beam, and proceeds to the study.In this process it provides access to ultrasound at different points in the test vessel projection.
For example, when scanning carotids and cerebral arterial access through the skin and muscles of the neck, as well as in cranium connection with the spine (craniovertebral joint) over the temporal bone of the occipital protuberance of the head, in the region of the orbit.When scanning of the aorta and its branches, the renal and hepatic vascular physician to apply the gel and it works on the skin of the chest and abdomen, with limbs study - on the skin of the hands and feet corresponding to the course of the great vessels.In the latter study, the patient may be asked to stand up for scanning in a standing position (it is important to assess the patency of the perforating veins, reporting the deep and superficial veins of legs), as well as perform a Valsalva maneuver (straining) to clarify the changes in blood flow in the veins at the moment the sample.
At this time, all information received scanner is processed by digital devices and displayed on a computer monitor a physician as a color image of blood flow and quantitative characteristics of the vessel, the physician evaluates the results and carries out interpretation.
examination time is 20 - 30 minutes, after which the doctor gives his opinion of a patient for later his doctor.In the event of a planned inspection the patient goes home and at inspection on emergency indications are hospitalized in the profile department for further observation and treatment.
Decoding performance duplex scanning of vessels
Not every patient will be able to understand written in prison after scanning.Basically, try to understand this is not necessary, because this information is purely medical in nature and is intended for professionals with expertise in this area.Still, everyone has the right to know about the results of various diagnostic methods, so we have a little stop on the main indicators of duplex scanning of arteries and veins, and try to understand what may be indicative of normal blood vessels, but what about the pathology.
So in conclusion the patient can see the following characteristics (may vary depending on the group studied vessels):
1. The quantitative characteristics of the Doppler spectrum:
- peak systolic velocity of blood flow
end-diastolic flow velocity - the time-averaged maximum velocity
blood flow - the average time
blood flow - resistance index
- pulsator index
The practical significance of these indicators has a systolic velocity, since it is he's talking about the presence of a stenosis (narrowing) of the vessel, for example, as a result of atherosclerotic lesions of the vascular wall.The second - the fourth indicators are mainly used for formulas, counting the last two, also of practical importance - for example, the higher the resistance index, the greater the resistance of the vascular wall is the bloodstream, as it loses its elasticity that occurs in hypertension, diabetic angiopathy, parietalthrombi, atherosclerotic plaques.Normally, some vessels, such as the brachiocephalic trunk and subclavian arteries have a high resistance.
2. Qualitative characteristics:
- estimated straightness artery or presence of deformations, crimped stroke, aneurysms (protrusions) or other anomalies
- measurement of the diameter of the artery (using cross-sectional plane)
- measurement of intima - media (inner endothelial lining of arteries andaverage musculo - elastic shell)
These indicators show the degree of narrowing of the arterial hypertension, the presence of wall overlays (thrombi, atherosclerotic plaques).In case of detection of thrombus plaque describes their location, size, echogenicity (high, medium, low), the structure of the surface (smooth, rough, with ulceration of plaques).
- for veins in conclusion indicates the presence or absence of enlargement, varicose transformation, insolvency vein valves (which contributes to stagnation of blood in them and varicose), compressible Is Vienna during compression (pressure-sensitive sensor is determined the elasticity of the vein wall), the definition of retrograde (reverse)blood flow during Valsalva maneuver (normal sample should be negative).
These characteristics must be evaluated by the attending physician - internist, cardiologist, neurologist, vascular surgeon to determine the future tactics of the patient and select the best method of treatment.
Complications duplex scanning of vessels
complications in the survey process does not occur, so this method can rightly be called one of the safest methods of diagnosis.
therapists Sazykina OJ