Vascular Ultrasound

Vascular ultrasound is a study that displays the structure and characteristics of blood flow in peripheral and main vessels, in arteries and veins located in internal organs. Ultrasound Dopplerography and duplex angioscanning are possible. Depending on the diagnostic tasks, the vessels of the neck and head, the arteries of the extremities, the veins of the lower extremities, the abdominal aorta with branches, the inferior vena cava and branches are examined, the ankle-brachial index is determined.

Preparation

Mandatory preparation for vascular ultrasound is not required. If a study of the abdominal aorta is performed, it is recommended to abandon the use of products that provoke flatulence for 3 days. It is necessary to exclude legumes, muffins, confectionery and carbonated drinks from the menu, reduce the amount of fresh fruits and vegetables. The procedure is best performed after 8-12 hours of hunger. To obtain informative results of the examination of the cerebral vessels and neck vessels on the day of the examination, it is necessary to refrain from coffee, strong tea, alcohol and other substances that change vascular tone.

What shows

Ultrasound Dopplerography allows you to assess the patency of the vessel, determine the direction and speed of blood flow. There is no visualization of blood vessels, it is impossible to clarify the cause of deviations from the norm. Duplex scanning displays the anatomy of the vessel on the monitor: thickening of the walls, tortuosity of the course, blood clots, plaques, developmental anomalies, postoperative joints. The study also provides information about the speed and direction of blood flow. With triplex scanning, the image of the vessel is colored. In addition to assessing blood flow and visualizing the structure of the vessel, it is possible to more accurately judge the direction of blood flow, identify patency disorders and determine their cause. Ultrasound of the vessels determines the following pathologies:

• Atherosclerosis of blood vessels. Ultrasound signs of atherosclerosis are a decrease in the elasticity and elasticity of the vessel, thickening of the intima media layer, a change in the uniformity of blood flow, the presence of atheromas. Stable plaques are visualized as homogeneous hyperechoic structures with a clear contour; unstable – as homogeneous hypoechoic foci; calcified – as heterogeneous formations with hyperechoic inclusions.
• Arterial hypertension. Ultrasound is used to diagnose the causes of hypertension. Elevated blood pressure may be the result of atherosclerosis (plaques are detected), stenosis (narrowing of the lumen is recorded), kidney circulatory insufficiency. The characteristic features of the ultrasound picture are thickening of the artery walls, an increase in the pulse wave velocity from the carotid to the femoral artery to 12 m/s or more, LPI less than 0.9.
• Violation of cerebral circulation. Disorders of blood circulation in the brain include strokes, transient ischemic attacks, insufficient blood supply to the brain. Ultrasound reveals high blood pressure, a violation of the elasticity of the vascular wall, its protrusion (aneurysm), the formation of an inhomogeneous structure (blood clots), kinks and narrowing of the vascular lumen.
• Varicose veins. The ultrasound method allows you to determine the cause of varicose veins, assess the degree of blood flow disorders. An uneven expansion of the vascular lumen, a change in the trajectory of the superficial veins, hyperechogenicity of the walls, insufficiency of the valve apparatus are diagnosed.
• Thrombophlebitis and deep vein thrombosis. In patients with thrombophlebitis, inflammatory changes and subcutaneous vein thrombi are detected. With deep vascular thrombosis, the nature of the thrombus is determined. A floating thrombus is characterized by tip mobility, heterogeneous echostructure, and uneven surface. Embologicity is higher with reduced echogenicity or anechogenicity of the clot. An occlusive thrombus causes a blockage of the vessel, a parietal thrombus locally reduces the speed of blood flow.

Ultrasound data indicate the nature of vascular damage, but cannot be used in isolation to make a diagnosis. Ultrasound examination is part of the diagnostic process, complements and confirms the results of examination, survey and laboratory blood tests.

Advantages

In comparison with X-ray angiography, CT and MRI of vessels, sonographic methods of vascular examination are more accessible, allow you to quickly get results, have no contraindications and side effects associated with the introduction of contrast or radiation exposure. The disadvantage is not always sufficient information content, the impossibility of examining small vessels. Vascular ultrasound has become widespread due to its non-invasiveness and low cost.