What does the procedure of ultrasound of the vessels of the head and neck show?

1 The essence of the

technique Ultrasonic doppler ultrasound( USDG) is a combination of ultrasound and Doppler-based studies. Simplified technology can be represented as follows: reflected ultrasonic waves with traditional ultrasound draw a sketch of the structure of the walls of blood vessels, and Doppler ultrasound shows the dynamic parameters of the movement of red blood cells along them. Using a computer, these two pictures are superimposed, which gives a complete picture of the movement of blood through the blood vessels. At the same time, color coding is used to ensure visibility of blood flow and the presence of defects.

There are 2 important directions in the research - transcranial ultrasound( examination of the brain vessels) and UZDG brachiocephalic vessels( examination of the cervical vessels).In order to obtain a complete picture of the blood supply to the brain, these studies are usually performed together. Diagnosis in this case combines the definition of the state of vertebral, subclavian and carotid arteries, cervical veins and the main cerebral arteries.

To obtain a picture of the vessels of the neck and head on a computer monitor with the help of special sources, an ultrasonic wave radiates, which, permeating the vessels, is reflected from the red blood cells depending on the direction and speed of their movement. Reflected waves are received by sensors and converted into an electrical signal, which forms a sketch in real time. When there are anomalies in the vessels such as spasms, constrictions, thrombi, the blood flow changes, which is immediately fixed on the monitor.

Thus, depending on the equipment used, it is possible to decide how to test the vessels in several ways. Dopplerography allows one to evaluate one function - the permeability of the vessels of the head and neck;duplex scanning - the structure of blood vessels and the speed of blood flow, and triplex scanning conducts examination of vessels in three directions - the structure of vascular tissues, the dynamic parameters of blood flow, a complete assessment of vascular patency in color format.

2 Diagnosis

The functional state of the vascular system is assessed by UZDG by the following elements: vertebral veins and arteries, general and internal carotid artery, basilar artery, inner and anterior jugular vein, subclavian vein and artery. After examination of these vessels of the neck and head, the following results can be obtained:

1. Investigation of the venous blood flow of the neck vessels.
2. Obtaining quantitative parameters of the blood flow of the main arteries.
3. Assessment of hemodynamic characteristics.
4. Establishment of the presence of an aneurysm in the cerebral vessels.
5. Definition of vascular causes of headaches, intracranial hypertension, angiospasm.
6. Determination of the state of stenotic tissues - echogenicity, integrity, thickness of the membranes.
7. Timely diagnosis of stenosis, the definition of vascular narrowing and patency.
8. Determination of the geometric characteristics of blood vessels.
9. Detection of vascular pathologies at an early stage.
10. Assessment of the impact of congenital malformations and various diseases on the state of the vessels of the head and neck.
11. Determination of the condition of nearby tissues to assess the possibility of their effect on blood supply.

Methods of ultrasound can solve the problem of how to check the vessels all over each specific artery or vein. It is possible to evaluate the following characteristics at any point of the head vessels: the canal diameter and wall thickness, the diastolic and peak systolic velocity, the nature of the blood flow, the degree of stenosis and the state of the vessel before and after the lesion, the pulsation and resistive index of resistance, and other parameters.

3 Purpose of examination

USDG has a high informative ability for a number of pathologies. Such studies of the vessels of the head and neck make it possible to diagnose and find out the causes of many diseases. For this purpose, UZGD is shown under the following circumstances:

1. Frequent headaches and cases of unexpected memory loss.
2. Increased cholesterol concentration in the blood.
3. Noise background in the ears or head.
4. Appearance of signs of clotting of blood.
5. The occurrence of violations of venous blood outflow from the brain.
6. Frequent dizziness, especially when the head turns.
7. Vegeto-vascular problems: diabetes, hypertension, heart attacks, etc.
8. Manifestation of symptoms of cerebrovascular disease, vertebro-basilar insufficiency, transistor ischemic attack, stroke.
9. Detection of atherosclerotic disorders.
10. Pulsating foci in the neck.
11. Osteochondrosis of the spine.

Conduction of UZGD is recommended for people suffering from excessive weight, when they reach the age of 45-50 years old and have close relatives of people who have suffered a stroke or heart attack;before carrying out complex surgical treatment.

4 Duration of the procedure

The total duration of the examination procedure is about 45-60 minutes, with the study of the vessels of the head taking place within 25-35 minutes, and the cervical vessels - 20-25 minutes. Surveys are conducted in a supine position on the back with a slightly upturned head. To avoid interference in the installation area of ​​the sensors, a special gel is applied to the skin. Initially, the neck is examined, by smoothly moving the sensor along the blood vessels. Ultrasound examination of the brain is carried out through the so-called temporal windows;sensors are installed in the temporal region.

Various methods of loading are used in the research. The most common functional loads: light flashes with a certain rhythm;irritation of the vestibular apparatus;various sound effects;frequent blinking, different ways of breathing. If there is a suspicion of having problems with the spine, the head turns.

5 Processing of results

The accuracy of the diagnosis depends on the correct interpretation of the results. Their decoding is carried out in the following directions: parameters of the blood flow in the vessels;character of the systole;the highest flow rate;diastolic parameters, i.e.minimum flow rate;relationship between speeds;The resistivity index is equal to the ratio of the difference between systolic and diastolic velocities to diastolic velocity. The norm of each indicator has an individual character for each type of vessel.

The following conditions are used as the norm for different vessels:

1. The minimum thickness of the artery wall is 1 mm, at border normal sizes - 1.2-1.3 mm.
2. There should be no flow turbulence in the branches of the vessels.
3. Complete absence of arteriovenous malformation.
4. Clearness and visibility of the lumen.
5. There should be no signs of compression - mutual compression between the vessels.
6. The diameter of the vertebral arteries is the same and is 2 mm.
7. Blood flow velocity to the sixth cervical vertebra is not more than 0.3 m / s.
8. In the carotid artery: the systolic velocity should not exceed 0.9 m / s, the diastolic velocity should not exceed 0.5 m / s.

6 Possible lesions of

When performing UZDG, changes in blood vessels and blood flow are revealed, which makes it possible to find out the causes of a number of pathologies and clarify the diagnosis. Based on the results of the examination, a treatment regimen is made and its effectiveness is monitored. All revealed violations are divided into 2 groups: anomalies with characteristic ultrasound symptoms( atherosclerosis of stenosing type, aneurysm, thrombosis, malformation) and pathology without specific ultrasound manifestation( non-stenosing atherosclerosis, angiopathy, vasculitis), which are estimated by indirect signs.

The following signs of pathologies determined by carrying out UZDG can be distinguished:

1. Nonstipating atherosclerosis can be assumed by a change in the structure of large arteries, uneven distribution of echogenicity, increased thickness of the vascular walls. Doubts may arise at a thickness of 1.1-1.3 mm, and are considered anomalous phenomena at a height of 1.3 mm.
2. Stenosing atherosclerosis is fixed when atherosclerotic plaques are detected. The plaque structure is assessed taking into account the risk of embolism.
3. Vasculitis is determined by taking into account the stage of the disease for such parameters: diffuse lesion of the walls, disruption of distribution and separation of layers, abnormal echogenicity, symptoms of inflammatory reaction.
4. Temporal arteritis is detected by a diffuse increase in the wall thickness of the superficial temporal artery or its branches with reduced echogenicity.
5. Diabetes mellitus manifests itself in the form of obvious signs of macroangiopathy or microangiopathy.
6. Malformations of veins and arteries are composed of abnormal vascular branches or arteriovenous fistulas. The branches are clearly hypertrophied and affected by hyalinosis, calcification, lipase infiltration. There is thinning of the walls with signs of hemorrhages.
7. Hypoplasia of vertebral arteries is a common pathology. It is characterized by a decrease in the diameter of the vessel to 1.9 mm or less. The ultrasound picture depends on the degree of development of pathology and its influence on hemodynamics. A fairly common disorder is the incorrect entry of the vertebral artery into the canal of the transverse processes of the cervical vertebrae.
8. Extravasal compression occurs with external pressure on blood vessels. When UZDG neck often found the causes of compression associated with an increase in the size of the thyroid gland and lymph nodes, as well as the growth of osteophytes in the cervical spine. Detection of extravasal compression, provoked by tumors of a different nature.

Ultrasonic dopplerography is a modern diagnostic method. In the study of the vessels of the head and neck, it is possible to determine a number of pathologies at an early stage. This method can establish the causes of a number of chronic manifestations. Using UZDG, you can develop the most effective treatment regimen and test its effectiveness.