Ultrasound and ultrasound of the vessels of the head and neck. Who is indicated for vascular constriction of the head and neck: how it is performed, what the results of the study mean for vascular constriction of the head and neck

Ultrasound scanning of the vessels of the head and neck is a modern and accurate diagnostic method that helps to identify diseases at the initial stage. It shows changes and pathologies in the study area using ultrasonic waves.

This method is absolutely safe for both adults and children. This procedure is carried out with the help of a specialist who applies a special gel to maintain continuous contact and provides an acoustic connection.

This article will be useful to all users because vascular disease is very dangerous and can lead to death if you do not temporarily consult a doctor. In this article you will learn how and why to undergo an ultrasound scan, the principle of the study, the pros and cons of this procedure.

To be clear, this is an ultrasound examination method combined with Doppler ultrasound, through which pathological changes in blood vessels are diagnosed and blood circulation parameters are determined.

There are several research modes. In practice, each of them can be used individually or together (to increase the accuracy and information content of the diagnosis), because duplex scanning of the vessels of the head and neck differs from Doppler ultrasound.

The Doppler ultrasound mode is designed to study the structure of the vessel and nearby tissues. As a result of duplex scanning, it is possible to obtain accurate data on the state of blood flow.

Ultrasound Dopplerography of the vessels of the head and neck is based on changing high-frequency sound vibrations that are not perceived by the human ear. Special sensors emit ultrasonic waves that are reflected from moving blood elements (this phenomenon is called the Doppler effect).

The displayed waves are captured by the device and, converted into electronic pulses, are displayed on the monitor in the form of images and graphs. The data obtained is intended to measure the speed of blood flow and determine the structure of blood vessels. The entire process takes place in real time.

In addition, the examination process is completely painless for the patient. This is a non-invasive (without damaging the skin) method of research. Unlike MR angiography, there is no need to use contrast for ultrasound diagnostics.

Having put together the main advantages - safety, painlessness, simplicity and absence of contraindications, we can consider this method as the main one. In this regard, even for newborn children, vascular ultrasound is also the most preferable method for diagnosing vascular diseases.

Ultrasound examination of the vessels of the head and neck (USDG of the vessels of the brain and neck) is based on the Doppler effect. A distinction is made between USDG of the cerebral vessels (transcranial USDG) and USDG of the vessels of the neck (USDG of the brachiocephalic vessels). Very often, these two studies are carried out together, which creates a holistic picture of the vessels supplying the brain with blood.

The technique includes the study of the carotid arteries, subclavian and vertebral arteries, veins of the neck, as well as the main arteries of the brain.

The image during ultrasound examinations of the vessels of the head and neck is obtained due to the fact that ultrasonic waves emitted by special ultrasound sensors, passing through a blood vessel, are reflected differently from blood cells (erythrocytes), depending on how they move inside the vessel (depending on direction and speed of blood flow).

The reflected waves are picked up by an ultrasound probe and, after being converted into electrical impulses, are displayed on a monitor in real time in the form of graphs and color photographs that represent the flow of blood through the blood vessels.

Ultrasound scanning of vessels allows you to see vessels “from the inside” in real time, thereby making it possible to determine changes in blood flow in vessels associated with spasm, narrowing or thrombosis. During Doppler sonography, only one function can be studied - the patency of the vessel.

In addition, the clinic performs duplex scanning of blood vessels (USDS), which allows one to simultaneously evaluate two functions - to study the anatomy of blood vessels and assess the speed of blood flow, as well as triplex scanning - to study three functions, including: study of the anatomy of blood vessels; blood flow assessment; accurate assessment of vessel patency in color mode.

Doppler ultrasound of the vessels of the neck and brain reveals whether there are any obstructions to the flow of blood in the vessels. The method helps to quickly, without prior preparation, in real time, determine:

early lesions of blood vessels (arteries), atherosclerotic or inflammatory in nature;
state of venous blood flow;
presence and degree of arterial obstruction;
blood flow speed through the vessels being studied;
changes in the elasticity of the walls of blood vessels, including age-related ones;
common causes of dizziness: congenital vascular anomalies - arterial hypoplasia (small diameter), pathological tortuosity of the vessels;
causes of headache: increased intracranial pressure and vasospasm

This diagnostic method is used in almost all medical fields and allows you to identify any structural changes in an organ, identify a violation of its function, and determine the probable cause of pain. In some cases, such a study helps to avoid surgical intervention, and this is also an important advantage of ultrasound. Therefore, if something worries you, feel free to sign up for an ultrasound.

The areas of application of ultrasound are varied. Ultrasound examination can detect diseases of the liver, pancreas, bladder and other abdominal organs, as well as kidneys and adrenal glands. Ultrasound is actively used in obstetrics and gynecology, for example, to diagnose inflammation, uterine fibroids, female infertility, and ovarian cysts.

Using ultrasound of the vessels of the head and neck, you can:

quantify the speed of blood flow in the main arteries of the head and neck;
identify early vascular disorders, including those caused by blood clots and atherosclerotic plaques;
determine the presence of stenosis (narrowing) of the arteries, as well as their significance;
find out the causes of headaches (increased intracranial pressure, vasospasm);
assess the condition of the vertebral arteries;
assess the state of venous blood flow in the vessels of the neck;
diagnose the presence of cerebral aneurysms

Thanks to such a study, it is possible to determine the gestational age, fetal weight and expected date of birth, and see deviations in the development of the fetus. Another area of application of ultrasound is mammology. This is the science that deals with diseases of the mammary glands. The fact is that a breast examination by a doctor cannot give a complete picture. Ultrasound provides a more accurate diagnosis.

This method helps in monitoring the treatment of various neoplasms in the mammary gland (cysts, tumors), and allows you to track the effectiveness of treatment. Ultrasound is a very informative research method. In many cases, it can replace several other, more traumatic or harmful studies.

In what cases is ultrasound examination of the vessels of the head and neck performed:

If you complain of headaches, sudden loss of consciousness;
For dizziness associated with turning the head;
With noise in the head and ears;
During episodes of sudden weakness or numbness of an arm or leg, speech impairment;
For vertebrobasilar insufficiency, cerebrovascular disease, transient ischemic attack, stroke;
In the presence of vegetative-vascular dystonia, hypertension, diabetes mellitus, angina pectoris, heart attack and other chronic diseases;
Patients with excess body weight;
When cholesterol levels increase;
With changes in the blood coagulation system;
If there is a suspicion of difficulty in venous outflow from the cranial cavity;
Doppler ultrasound of the head and neck vessels is used as a screening study to assess atherosclerotic lesions of the blood vessels of the brain and heart;
If the patient is over 40 years old, if relatives have heart attacks, strokes, arterial hypertension, atherosclerosis;
In addition, Doppler ultrasound is used to assess the effectiveness of treatment and to determine indications for surgery.

Using this type of study, the growth of follicles in the ovaries and the process of ovulation are monitored. Endometrial pathology can be identified: hyperplasia and polyps. Ultrasound examination also allows for timely diagnosis of cancer.

Under what circumstances can ultrasound of the vessels of the neck and head be prescribed?

Regular ultrasound examination of the brachiocephalic region is recommended for everyone. If the patient has certain symptoms, such as severe headache, loss of consciousness, noise in the head and ears, speech impairment, numbness in the limbs, weakness, etc., the doctor prescribes an ultrasound scan of the vessels of the head and neck.

Such diagnostics, for the most part, are vital and for this reason mandatory to identify the presence of cerebrovascular insufficiency, accompanied by loss of visual fields, weakness in the limbs, loss of consciousness, dizziness and other symptoms.

In addition, the indications for conducting the above study are the following:

absence or asymmetry of pressure and pulse in the hands;
the presence of risk factors for atherosclerotic development - increased levels of triglycerides and cholesterol in the blood,
smoking,
overweight,
high blood pressure and so on;
arterial hypertension, especially chronic;
suffered a stroke or heart attack, pain in the calf muscles while walking;
presence of pulsating formations in the neck area; data regarding diseases of close relatives with strokes,
heart attacks and diabetes;
epileptic seizures.

At the present stage, Dopplerography (so-called duplex) examination is used to diagnose neck vessels. With its help, you can “examine” a vessel from different angles, examine its walls in detail, changes in diameter, lumen and many other indicators.

How is the research going?

Preparing for an ultrasound is quite simple. To do this, the patient should free the study area from clothing and jewelry and lie on his back on a specially prepared couch. In order to ensure close contact of the device sensor with the skin, a gel is applied to the examination area. The scanning process lasts no more than 45 minutes and the procedure is completely painless.

During a transcranial ultrasound examination, the sensor is placed in the area of the temporal bone, the back of the head or above the orbit. To diagnose large vessels in the neck area, a special cushion is placed under the patient’s head to obtain more accurate results.

Then, after installing the ultrasound sensor, the specialist studies the constantly changing images of sections of the object of study displayed on the monitor. Unusual sounds emanating from the device's speaker accompany the measurement of blood flow.

All information obtained during the scanning process is recorded by the device and stored in the patient’s electronic database. Immediately upon completion, the specialist can comment on the results of the diagnostic examination to the patient, but the conclusion of the ultrasound scan will be made only by the doctor who referred for the examination.

A special transparent gel is applied to the skin of the area being examined, which is necessary to ensure close contact between the skin and the ultrasound sensor of the device.

Having installed the ultrasound sensor in a certain position, the doctor examines continuously changing images (“slices”) on the monitor. During the examination, you may hear unusual sounds from the ultrasound machine's speaker, which are caused by the measurement of blood flow in the blood vessel.

Doppler ultrasound of the cerebral vessels is performed through the so-called “ultrasound window” located 2-3 cm above the zygomatic arch. The temporal bone absorbs ultrasound signals to the least extent, which makes it possible to study the speed of blood flow through the anterior, middle, and posterior cerebral arteries.

Once the ultrasound examination is complete, the gel will be wiped off from your skin. The examination is painless and does not exceed 45 minutes. Immediately after the examination, you can begin your normal lifestyle. The data is checked section by section, sequentially.

Each segment has its own parameters, which are compared with the established norms of vascular ultrasound, according to special tables. A separate interpretation of the ultrasound examination of the vessels of the head and neck includes the following values:

pulsation and resistive indices,
artery wall thickness,
diameter,
degree of stenosis,
nature of blood flow,
linear blood flow velocity

The information obtained during the study is entered into the patient’s electronic database and a printed copy is provided to him. In addition, the identified changes are recorded on thermal paper in the form of small photographs and given to the patient.

Carrying out the procedure

Usually the conclusion is issued immediately after the end of the study. The ultrasound doctor interprets the results, he can also discuss the results with you, but the final word remains with the doctor who referred you for the ultrasound.

Most ultrasound examinations are non-invasive (no needle or injection) and are usually painless. Ultrasound is widely available and less expensive than other imaging modalities.

No ionizing radiation is used during ultrasound. Ultrasound scans provide a clear picture of soft tissue that is not visible on x-ray images. Ultrasound examination is carried out in real time. Standard diagnostic ultrasound studies did not reveal any harmful effects on humans.

Ultrasound is one of the tools used to diagnose vascular disease, but it does not replace angiography, including angiography performed on a computed tomography or magnetic resonance imaging scanner, which may be needed to clarify the diagnosis.

Small vessels are more difficult to evaluate with ultrasound than larger ones. In some cases, the bones of the skull do not allow for a full examination of the vessels of the head; Calcifications that occur in blood vessels as a result of atherosclerosis can interfere with the passage of the ultrasound beam.

The diagnostic value of ultrasound, as well as other diagnostic methods (X-ray, mammography, computed tomography and magnetic resonance imaging, etc.) is directly proportional to good equipment and the professionalism of the doctor. No special preparation is required to perform vascular ultrasound. The examination is carried out on a couch in a lying position; it is necessary to remove jewelry and all clothing from the head and neck.

Ultrasound data is assessed taking into account the clinical picture; the doctor can study the medical history and ask about complaints before the study. A special gel is applied to the skin of the head and neck to ensure closer contact with the skin of the ultrasound transducer. Doppler ultrasound of the cerebral vessels is done through an “ultrasound window”, which is located 2-3 cm above the zygomatic arch.

The temporal bone does not absorb sound signals well, so through the “window” in the temporal part it is possible to study the speed of blood flow through the cerebral arteries: anterior, posterior and middle. During the examination, unusual sounds are heard from the speaker of the device, which are reproduced while measuring the flow of blood passing through the vessels.

After completion of the study, the gel is removed from the skin. The research time does not exceed 45 minutes. The conclusion is issued immediately after the ultrasound examination; the final conclusions remain with the doctor who referred for the ultrasound. Information about detected changes is given to the patient in the form of small pictures on thermal paper.

Immediately after the study, the patient can begin his normal lifestyle. Standard ultrasound examination did not reveal any risk factors for humans. The advantages of ultrasound scanning are that it is performed in real time and gives an idea of the soft tissues.

During the examination, no ionizing radiation is used; ultrasound scanning is widely available at a reasonable price and is painless. At the same time, the bones of the skull in some cases do not make it possible to fully conduct a study of the vessels of the head. Calcifications that result from vascular sclerosis can also interfere.

It is difficult to assess the condition of small vessels using ultrasound. The value of ultrasound examination, like other diagnostic methods, depends on the equipment and professionalism of the doctor. Ultrasound does not replace angiography done on a computer or magnetic resonance imaging scanner, which may be needed to clarify the diagnosis.

What does ultrasound scan show?

The most common pathology detected by ultrasound of neck vessels is the presence of atherosclerotic plaques in the lumen of the vessels. Since the symptoms of circulatory disorders, noticeable to the patient, develop only after blocking the lumen of the vessel by more than 60%, the process of formation of plaques and blood clots can proceed asymptomatically for a long time.

Plaques during ultrasound of neck vessels can be of various shapes and compositions. The researcher’s task is to describe in detail the composition of the plaque and its location.

Often atherosclerotic plaques disintegrate and blood clots form on them, which can completely block the lumen of the artery or break off, causing blockage of other, smaller vessels. These conditions often result in the development of a stroke (death of a section of brain tissue) due to acute cerebrovascular accident.

Stroke is a disease accompanied by high mortality (about 40%), and more than half of people who have had a stroke become disabled. Recently, strokes have been developing in people at an increasingly younger age (up to 60 years).

Factors contributing to the development of cerebral stroke: smoking, diabetes, high blood pressure, excess body weight, female gender, the presence of a similar disease in blood relatives.

If such factors are present in a person, he needs to undergo a study of the vessels of the neck as early as possible. It is also necessary to undergo a study of the vessels of the neck if you are worried about dizziness, chronic headaches, problems with coordination, memory and speech.

Rare cases that are diagnosed by ultrasound of the vessels of the neck include dissection of the wall of the carotid artery - detachment of its section followed by thrombosis.

Mandatory information obtained from ultrasound of neck vessels is a study of the volume of blood that flows through all neck vessels to the brain per unit time. Adequate blood supply to the brain is the main factor that is taken into account when assessing the pathology of cerebral circulation.

To do this, add up the volumetric blood flow velocity in all four vessels supplying the brain, namely in the internal carotid arteries and in the vertebral arteries on both sides. A correctly conducted study approaches the accuracy of the results obtained from positron emission tomography.

Ultrasound scanning of the vessels of the head and neck is done to evaluate the functional characteristics of the vessels responsible for supplying the brain with blood enriched with oxygen and nutrients:

vertebral arteries and veins,
two carotid arteries (common and internal),
basilar artery,
anterior and internal jugular veins,
subclavian artery and vein

Normally, in a healthy person, about 15% of the blood that the heart pumps per minute ends up in the vessels of the brain. Using ultrasound of the neck vessels, you can very accurately calculate exactly how much blood enters the brain.

Thanks to the use in clinical practice of the informative method of Doppler ultrasound of the vessels of the head and neck, diagnostic specialists conduct research, as a result of which:

The vertebral arteries and venous blood flow of the vessels of the neck are studied,
A quantitative assessment of the blood flow velocity of the main arteries is carried out,
The state of blood movement in the vessels is assessed - hemodynamics,
Aneurysms are detected in the vessels of the brain,
The root causes of headaches, the appearance of vasospasm and increased intracranial pressure are determined,
The condition of the vessel wall is assessed, characterized by its integrity, echogenicity, thickness of the inner and middle membranes,
Stenosis, degree of narrowing, patency (lumen diameter) of blood vessels are diagnosed,
The geometry of blood vessels is studied,
The condition of early vascular disorders is assessed,
Possible vascular lesions resulting from previous diseases or congenital defects are identified,
The condition of the tissues surrounding the arteries and veins, the reason for their effect on the vessels and much more are studied.

The range of ultrasound examinations with duplex scanning of the vessels of the head and neck is quite wide. The use of this technique has made it possible to reduce the time required to diagnose diseases that previously took months to identify.

Among other things, for a more in-depth study of the state of the cerebral vessels, an ultrasound scan of the vessels of the head and neck with functional tests is performed, which uses special loads on the body:

Rhythmic light flashes

Stimuli of the vestibular apparatus,

Sound stimuli

Repeated (frequent) blinking

To determine a possible conflict between the vessel and the vertebra, a functional test is performed - turning the head. This allows you to determine if a vessel is pinched or pinched. Thanks to special stimuli, the localization, hemodynamic significance of stenoses and pathological tortuosity of blood vessels are most accurately determined.

Examination of children

Ultrasound examination can be performed on a child, regardless of his age. Doppler sonography is indicated even for newborn children, especially if the mother had a difficult or prolonged labor and there is a possibility of birth injuries to the head, soft tissues or spine.

The child does not need to do any preliminary preparation during this examination. The studies are carried out through the natural openings of the head - the fontanelles, and the results, as a rule, with a high degree of accuracy make it possible to determine the state of the brain and the degree of its trauma when passing through the birth canal.

Results of ultrasound of neck vesselsMoreover, today this method of ultrasound of the head and brain is considered mandatory in the first days of life in infants. This is how it is possible to promptly diagnose brain diseases and injuries to the blood vessels of the head, neck and spinal column, as well as soft tissues in children.

If birth injuries occurred at the birth of the baby, then the child requires timely assistance to prevent the manifestation of cerebral palsy and intracranial pressure. All these conditions can be successfully corrected with modern drugs, but provided that treatment is started on time and atrophic processes do not affect large nerves and soft tissues.

Ultrasound of the neck, as well as the head, takes place in an atmosphere that is comfortable for the baby. The devices do not make loud sounds, and the gel from an experienced ultrasound technician will always be warm. If the baby is too nervous, then the examination can be carried out by examining the child in the mother’s arms. However, such a need arises very rarely, since ultrasound examination is a completely painless and safe procedure. Every mother should do an ultrasound of her child’s blood vessels.

It is better to notice the disease in a timely manner and prevent dangerous consequences when the process is running. Ultrasound examination can also be performed during pregnancy to detect congenital malformations of the fetus. Even in utero, the important vessels of the baby’s neck and head, as well as internal organs, will be clearly visible. Visualization of fetal soft tissue is no different from that of an adult.

Sometimes the situation may be such that the unborn baby will need qualified help in the first hours of life. Identifying such pathologies during pregnancy provides a huge advantage: doctors can provide timely assistance, carry out the necessary surgical correction and save the baby’s life. Even in this case, Doppler ultrasound is completely safe for the mother and will not cause any harm to the unborn child.

It is difficult to imagine modern medicine without unique ultrasound equipment, the presence of which in clinics allows us to speed up the process of identifying pathologies. Ultrasound examination devices occupy a place of honor in almost every medical institution.

They significantly expand diagnostic capabilities:

quick confirmation of the diagnosis of appendicitis;
visual analysis of the fetal condition and monitoring of intrauterine development;
detection of kidney pathologies;
examination of the penis and testicles;
assessment of the prostate gland;
bladder dynamics, etc.

Ultrasound is aimed not only at identifying signs of pathology, but also the causes of its occurrence. These studies are evaluated in conjunction with clinical indications. Ultrasound examination has obvious advantages:

Affordable equipment, which makes it possible to equip every clinic;
No radiation exposure;
Simplicity and convenience of examination in technical terms;
Painless procedure (performed without the need for an incision or injection);
Excellent visualization of soft tissues (which cannot be said about an x-ray);
No harm to the body, which allows you to use it as needed;
Timely diagnosis of acute pathologies without the use of other diagnostic methods

An obvious disadvantage of such a study is the limited scope of diagnostics. It is worth noting that the device produces a non-specific image, so the accuracy of diagnosis depends on the experience of the specialist who examines the patient. In general, ultrasound is a reliable and convenient research method that takes a few minutes and does not require prior preparation.

Equipment for research

Among all the diagnostic equipment in medicine that has the ability to visualize the internal organs of a person, ultrasound equipment occupies an honorable place - it is widespread, provides reliable data, can be used for diagnostics in any field of medicine and shows results that are convenient and easy for a specialist to read.

According to the technical level, which determines the quality of the diagnostic information obtained, ultrasound machines are divided into four main groups:

Simple ultrasound scanners.
Ultrasound devices of medium technical class.
Ultrasound scanners with advanced capabilities.
High-end ultrasound machines (also called high-end).

Simple ultrasound scanners are usually portable devices. The number of reception and transmission channels in them is usually no more than 16. Mid-range ultrasound machines often have 32 reception and transmission channels. Ultrasound devices of a higher class most often have up to 64 reception and transmission channels. Very often these are devices with color Doppler mapping.

At the time of ultrasound examination, full contact of the device’s sensors with the patient’s body at the micro level must be ensured. For these purposes, special gels are used. The usual composition of the gel: glycerin, sodium tetraborate, styrene copolymer with maleic anhydride, purified water.

To perform research, a disposable or reusable biopsy tip can be used. Such attachments are most often attached directly to the body of the ultrasonic sensor. The biopsy attachment for the ultrasound sensor can have either a fixed or variable needle insertion angle. In the latter case, a device called a puncture adapter is used.

In this case, a special multi-angle attachment is used for the ultrasound sensor, and the sensor itself is positioned strictly perpendicular to the area under study. The puncture adapter for the ultrasound sensor must be selected taking into account the manufacturer and even the specific model of the sensor. During examination, the biopsy needle is inserted manually, and ultrasound equipment helps to more accurately determine the position of the needle in relation to the organ being examined.

Ultrasound devices of a high technical class have channels, as a rule, 64 or more - for example, 512. These are modern high-tech devices with color Doppler, as well as the ability to process information using a digital system. High-end ultrasound machines are sometimes called digital systems or digital platforms.

Universal ultrasound machines are divided into three groups according to their operating modes:

Ultrasound scanners. These devices are designed for two-dimensional acoustic imaging of ultrasound results in black and white.
Ultrasound scanners with spectral Doppler. These devices in the medical environment are sometimes called duplex devices. Unlike simple ultrasound scanners, these devices have additional functions - using the Doppler method they can estimate the speed of blood flow.
Ultrasound machines with color Doppler mapping. These ultrasound scanners are also called color Doppler ultrasound machines. This group of devices is characterized by the presence of the maximum number of functions. Having all the modes of an ultrasound scanner with spectral Doppler, these devices have the ability to display a two-dimensional distribution of blood flow velocity and highlight them in color on a gray two-dimensional image of tissue.
Echoophthalmometer. This is an ultrasound device that is used in ophthalmology. Used to visualize all structures and tissues of the eye. The device produces results in the form of a one-dimensional or two-dimensional image.
Ultrasound machines for research inside blood vessels. This group of devices is not very extensive - these ultrasound machines are produced quite rarely and are not available in all clinics.
Ultrasound machine echoencephaloscope

Universal and specialized ultrasound machines have different functions. Ultrasound scanners can also have the ability to connect various ultrasound sensors, additional devices and devices to them, which complements their functions and expands the possibilities of use in a particular field of medicine.

Ultrasound Dopplerography of the vessels of the head and neck (Doppler ultrasound) is a diagnostic method that allows you to evaluate the vascular system of the relevant areas using ultrasound. Dopplerography gives an idea of the state of blood flow.

Duplex scanning is more informative, thanks to which you can visualize the vessel, find out the exact cause of the obstructed patency and see the vessels located in the cranial cavity. The most accurate method is color duplex scanning (triplex).

Indications for Doppler ultrasound

Doppler ultrasound allows you to identify risk factors for stroke and select patients for therapeutic, surgical and catheter interventions. You can monitor the condition of the affected arteries responsible for the appearance of symptoms of cerebrovascular accident.

Such a study is indicated in the following situations:

diseases of the heart and blood vessels: hypertension, history of acute myocardial infarction, hypotension;
a significant difference in pressure on the hands, absence of a pulse on one of them;
transient cerebrovascular accidents (transient ischemic attacks);
frequent headaches, including migraines, tinnitus;
vestibular disorders: dizziness, unsteadiness while walking;
impaired coordination of movements;
memory impairment, decreased concentration, poor sleep;
decreased vision or temporary blindness in one eye;
“flies” flashing before the eyes;
high risk of developing atherosclerosis: obesity, high cholesterol, diabetes, overweight, smoking;
operations on neck vessels;
pulsating formations in the neck;
previously identified pathology for control purposes;
convulsive syndrome;
syncope (fainting);
osteochondrosis of the cervical spine;
decreased sensitivity in the upper extremities.

Doppler sonography is not carried out in situations where a person is unable to lie on his back for a long time for any reason.

Advantages and disadvantages of vascular ultrasound

Advantages over other methods

Examination of blood vessels using ultrasound is a fairly informative and safe diagnostic method. There is no radiation exposure to the patient. Portable devices are easy to use directly at the patient's bedside.

It is not difficult to determine the location of blood clots and the extent of the atherosclerotic process. It is possible to monitor the condition of blood vessels and evaluate collateral circulation in real time. Already at the early stages it is possible to identify those changes that in the future may result in the development of a stroke.

This research method is available to absolutely everyone: most medical centers have the necessary equipment and specialists at their disposal. The price is quite reasonable.

Disadvantages of diagnostics

When examining small vessels of the brain, especially those located deep, it is difficult to assess their condition. Dense bone tissue does not transmit ultrasound well. This occurs when the study is performed through the bones of the skull.

How the research is carried out

Preparation for vascular ultrasound

Before the procedure you cannot:

smoke and drink alcohol;
drink tonic drinks: tea, coffee, energy drinks;
some medications (only with your doctor’s permission);
abuse salty foods.

You need to come to the examination in a calm state.

Ultrasound scanning technique

The necessary equipment is an ultrasound scanner with appropriate functions and a special sensor. The patient is placed on his back, his head is tilted back and a cushion is placed under his neck. The head is turned to the side. After a gel is applied to the skin to ensure close contact with the sensor, the sensor itself is installed in this place.

Ultrasound of vessels located in the neck area is carried out in three planes: longitudinal anterolateral, longitudinal posterolateral and transverse. The sensor slowly moves along the neck in the projection of the vessels.

When examining the arteries and veins of the brain, three approaches can be used: the region of the temporal bone, the orbital and occipital region, where the foramen magnum is located.

If necessary, functional tests are performed.

What you can see and appreciate

An image of the vessels that the sensor is scanning at that moment appears on the monitor. You can determine the diameter of the vessel, the thickness of the wall and its condition. Blood clots, atherosclerotic plaques, vessel narrowing, aneurysms, and congenital changes in the arterial and venous systems are detected.

Doppler ultrasound records the spectrum of Doppler frequencies produced by the blood flow. The screen displays a kind of graph in the form of waves, the nature of which depends on the intensity of echo signals at various Doppler frequencies from blood elements. Thanks to this study, it is possible to determine in which direction the blood flow moves and at what speed. Obstacles are detected that interfere with normal blood circulation.

The duration of the Doppler ultrasound procedure is on average 30 minutes, sometimes more. The result is given to you immediately.

Which departments are available for research?

Ultrasound scanning of the vessels of the head and neck is carried out in a certain sequence: the vessels of the neck, and then the vessels of the head.

Doppler ultrasound of neck vessels

Another name for the study of this department is ultrasound of the brachiocephalic vessels. The procedure allows you to assess the condition of both arteries and veins.

Doppler ultrasound of the brachiocephalic arteries is an assessment of the condition and blood flow in the vessels supplying the upper shoulder girdle, soft tissues of the head and the brain itself. These include: brachiocephalic trunk, vertebral, subclavian, common carotid, external and internal carotid arteries. Any pathology of these departments can seriously affect a person’s health and lead to impaired cerebral circulation.

Doppler ultrasound for cervical osteochondrosis

Particular attention should be paid to the importance and value of ultrasound of the brachiocephalic vessels for changes in the cervical spine. The vertebral arteries pass between the processes of the vertebrae.

With osteochondrosis, a decrease in the lumen of the intervertebral canal and compression of the arteries by bone outgrowths, hernial protrusions, and spasmed muscles may be observed.

With such changes, the appearance of vertebral artery syndrome is likely, when severe headaches, dizziness with attacks of nausea and vomiting are noted. When turning the head, a person may lose consciousness. Timely diagnosis of such changes helps to avoid serious consequences.

Doppler ultrasound of cerebral vessels

It is carried out only after assessing the condition of the neck vessels. This is the so-called transcranial vascular Doppler ultrasound. The technique allows you to assess the condition of the brain matter, main arteries and veins, collateral circulation and identify signs of intracranial hypertension.

Ultrasound examination of the MAG (main arteries of the head) is highlighted separately, since the pathology of these very vessels often leads to fatal consequences. In essence, these are the same brachiocephalic arteries, but those parts of them that are located in the cranial cavity.

Several areas are used for research.

Access through the orbit is necessary in order to assess the condition of the arteries supplying the eyes and other vessels in the surrounding area.
Thanks to transtemporal access (temporal bone), it is possible to see changes in the main cerebral arteries: anterior, middle, posterior and other large vessels. Intracranial hemorrhages (hematomas) are well detected.
When examined through the foramen magnum, pathology of the vertebral arteries and veins can be detected.

Nerve cells in the brain are extremely sensitive to lack of oxygen. Even a slight disruption of the blood supply can lead to serious neurological problems. The carotid arteries, which run along the lateral surface of the neck on both sides, and the vertebral arteries, located on the sides of the spinal column, deliver blood to the brain.

Today there is a safe and painless way to assess their condition - to conduct an ultrasound examination.

What is ultrasound scanning of the vessels of the neck and head?

Doppler ultrasound is an instrumental research method using ultrasound.

They are capable of penetrating body tissues and being reflected from structures of varying densities, which is recorded by a special sensor. The signals from the sensor are processed by a computer and the doctor sees an image of the organs and internal environments on the monitor.

Dopplerography is an additional ultrasound diagnostic function that allows you to evaluate the nature and speed of blood flow in the arteries and veins.

If blood moves towards the sensor, the computer colors it red in the image. If in the opposite direction, then blue.

When is transcranial Doppler ultrasound of the brain necessary?

Duplex scanning, as vascular ultrasound is also called, is prescribed by a doctor if a cerebrovascular accident is suspected. The following symptoms indicate this pathology:

bursting pain in the head;
dizziness, especially when changing body position and throwing back the head;
periodic darkening and flickering of spots before the eyes;
fainting;
progressive impairment of memory, attention, thinking;
noise in ears;
paroxysmal numbness, weakness in the limbs.

Direct indications for

Some systemic diseases occur with vascular damage and poor circulation. Therefore, to assess their progression and the effectiveness of treatment, the doctor prescribes an ultrasound examination of the blood vessels. It is shown when:

atherosclerosis;
diabetes mellitus;
after a cerebral stroke;
increased levels of cholesterol in the blood (hypercholesterolemia);
systemic vasculitis;
heart defects;
neurocirculatory dystonia;
obesity;
long history of tobacco smoking;
arterial hypertension;
head and neck injuries;
coronary heart disease.

All people over 55 years of age should undergo vascular ultrasound once a year if their immediate family members have had a heart attack, stroke, coronary heart disease, atherosclerosis or hypertension. This indicates a hereditary predisposition and a high risk of developing such conditions.

Contraindications

The study does not violate the integrity of tissues, is painless and does not have a negative effect on the body. Therefore, there are no absolute contraindications to its implementation.

Difficulties arise only if a person for some reason cannot take the position necessary for research.

Examination in children

Ultrasound examination is mandatory for all infants at the age of 1 month. This makes it possible to identify a violation of the blood supply to the brain at the earliest stages and correct it. Without timely diagnosis and treatment, this condition will lead to serious neurological problems and intellectual impairment in the child.

For older children, vascular ultrasound is prescribed for complaints of headaches, fatigue, mental retardation, decreased attention and memory. The study allows you to prescribe appropriate therapy and improve the child’s condition.

What does an ultrasound show?

During the examination, the doctor can determine the places of narrowing of blood vessels, the condition of their walls, the direction of blood flow and its speed. With atherosclerosis, it is possible to identify the location of cholesterol plaques and the presence of a blood clot on them. Thickening of the walls of the arteries and a decrease in their elasticity occurs with hypertension.

A change in the direction of blood flow occurs due to various obstacles in its path, dissection of the arterial wall, or the formation of an aneurysm - a sac-like protrusion of a vessel.

If the outflow of blood from the brain is disrupted, dilated veins will be found in which the speed of blood flow is significantly reduced.

How to make a diagnosis

To conduct the study, the person is placed on his back on a soft couch. A cushion is placed under the neck, the head lies without a pillow. The doctor applies a special gel to the sensor and skin - this is necessary for the passage of ultrasonic waves into the internal environment of the body.

The vessels of the neck are examined by pressing the sensor to its lateral surface. At this moment you cannot move your head or talk. During the procedure, the doctor will press the sensor several times to assess the elasticity of the blood vessels.

The vessels of the head are examined through the thinnest areas of the cranial bones: the orbit, temporal bone, occipital bone and foramen magnum. The sensor is placed on the closed eye, above the auricle and behind it. After this, the patient is seated and the back of the head and the place where the neck connects to the head are examined.

In this way, the doctor examines all the vessels that bring blood to the brain and carry it back to the heart.

The procedure takes about half an hour and does not cause any discomfort. During this procedure, the diagnostician may ask you to hold your breath, breathe frequently, and turn your head. This is necessary for the best image accuracy and assessment of the functional state of the vessels.

Is special preparation needed for the procedure?

On the day of the test, you should not take medications that affect blood pressure. It is advisable to refrain from drinking strong coffee, nicotine and alcohol - all these substances change the state of the vascular bed and can distort the results of the study.

Data decryption

Normal ultrasound findings of the neck and head vessels are as follows:

the common carotid artery (CAA) arises from the aorta on the left and from the brachiocephalic trunk on the right;
spectral wave in the common carotid artery (CCA): the speed of diastolic blood flow is the same in the external and internal branches of the carotid artery (ECA and ICA, respectively);
the internal branch of the carotid artery has no branches before entering the skull;
a large number of additional branches depart from the external branch of the OCA;
waveform in the internal branch of the CCA: monophasic, the speed of blood flow during diastole is greater than in the CCA;
waveform in the external carotid artery: triphasic, blood flow velocity during diastole is less than in the CCA;
The thickness of the vascular wall is no more than 0.12 cm.

Thickening of the walls of blood vessels indicates the beginning of atherosclerosis. With obvious atherosclerosis, the doctor sees the plaques and indicates their location and size. Vasculitis (inflammation of blood vessels) leads to diffuse thickening of the vascular wall and blurring of its layers.

The presence of communications between the venous and arterial beds is called arteriovenous malformation. Damage to blood vessels in the presence of diabetes mellitus indicates its advanced stage and decompensation.

Where can I take the study?

Today, the study is carried out in almost all clinics equipped with an ultrasound machine.

You can take it for free with a referral from your doctor.

The downside of this option is the long queue - sometimes you have to wait for several weeks. In addition, the patient cannot choose a convenient time for the study.

The study is carried out during examination and treatment in neurological, cardiological and other hospitals.

Private clinics offer ultrasound examinations for money, but quickly and at any convenient time. Their choice is quite wide, which makes the study accessible to most people.

Price

The cost depends on the level of the clinic and the qualifications of the diagnostician. The price range ranges from 500 to 6000 rubles. The average price is 2-3 thousand rubles.

Video about diagnostic ultrasound of head and neck vessels:

anatomy of the vessels of the head The normal functioning of the circulatory system creates a platform for the vital activity of all organs of the human body, each of its cells. Blood is a connecting element that provides organs and tissues with the oxygen and nutrients they need.

With even a slight disruption in the circulatory system, a person begins to experience discomfort and malaise. If the causes of abnormalities in the vessels of the neck and head are not identified on ultrasound in time, then in the future minor problems with well-being will develop into serious diseases.

A detailed ultrasound examination of the vessels of the neck, vessels of the head with determination of their structure, size, condition of the walls, assessment of the course of the vessels, as well as blood flow indicators provides doctors with the most accurate information in comparison with a conventional ultrasound examination.

What is ultrasound diagnostics of head and neck vessels?

The Doppler ultrasound mode is designed to study the structure of the vessel and nearby tissues. As a result of duplex scanning, it is possible to obtain accurate data on the state of blood flow.

Thanks to a modern ultrasound device with Dopplerography of the vessels of the head and neck, medical specialists can conduct a visual assessment and analyze a whole range of parameters using a method that is safe for health (this is due to the absence of radiation exposure to the body).
In addition, the examination process is completely painless for the patient. This is a non-invasive (without damaging the skin) method of research. Unlike MR angiography, there is no need to use contrast for ultrasound diagnostics.

Having put together the main advantages - safety, painlessness, simplicity and absence of contraindications, we can consider this method as the main one. In this regard, even for newborn children, vascular ultrasound is also the most preferable method for diagnosing vascular diseases.

What does an ultrasound scan of the vessels of the head and neck show?

vertebral arteries and veins
two carotid arteries (common and internal)
basilar artery
anterior and internal jugular veins
subclavian artery and vein

Thanks to the use in clinical practice of the informative method of Doppler ultrasound of the vessels of the head and neck, diagnostic specialists conduct research, as a result of which:

vertebral arteries and venous blood flow of neck vessels are studied
a quantitative assessment of the blood flow velocity of the main arteries is carried out
the state of blood movement in the vessels is assessed - hemodynamics
aneurysms are detected in the vessels of the brain
the root causes of headaches, vasospasm and increased intracranial pressure are determined
the condition of the vessel wall is assessed, characterized by its integrity, echogenicity, thickness of the inner and middle membrane
stenosis, degree of narrowing, patency (lumen diameter) of blood vessels are diagnosed
the geometry of blood vessels is studied
the state of early vascular disorders is assessed
possible vascular lesions resulting from previous diseases or congenital defects are identified
the condition of the tissues surrounding the arteries and veins, the reason for their effect on the vessels and much more are studied

Rhythmic light flashes
Stimuli of the vestibular apparatus
Sound stimuli
Repeated (frequent) blinking

How is an ultrasound examination of the vessels of the head and neck performed?

If the patient has certain symptoms, such as severe headache, loss of consciousness, noise in the head and ears, speech impairment, numbness in the limbs, weakness, etc., the doctor prescribes an ultrasound scan of the vessels of the head and neck, for which it is quite simple to prepare.

To do this, the patient should free the study area from clothing and jewelry and lie on his back on a specially prepared couch. In order to ensure close contact of the device sensor with the skin, a gel is applied to the examination area. The scanning process lasts no more than 45 minutes and the procedure is completely painless.

The data is checked section by section, sequentially. Each segment has its own parameters, which are compared with the established norms of vascular ultrasound, according to special tables.

A separate interpretation of the ultrasound examination of the vessels of the head and neck includes the following values:

ripple and resistive indices
artery wall thickness
diameter
degree of stenosis
nature of blood flow
linear blood flow velocity

In conclusion, seeing the entire clinical picture of the disease, the doctor makes his conclusion.

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

There is no need to prepare the patient for vascular ultrasound. There is no need for either fasting or an enema. It is only advisable not to drink tea or coffee before the scan, and also not to smoke, as this may affect the tone of the arteries.

This technique allows you to diagnose children (even newborns). Ultrasound scanning of blood vessels in a child is often performed for prophylactic purposes to exclude the development of vascular pathology.

To obtain the most accurate data, children should be examined when they are at rest. It is better to feed newborn babies about an hour before the procedure, so as not to distort the final result of the examination.

for frequent headaches;
sudden nosebleeds;
dizziness, tinnitus;
migraine;
fainting;
progressive disorders of thinking, memory, attention;
paroxysmal numbness and weakness in the limbs;
sudden general weakness, “midges” before the eyes, feeling of lack of air, etc.

in case of strokes, heart attacks;

head and cervical injuries;

pathologies that can cause compression of the arteries (enlarged thyroid gland, tumors);

atherosclerosis and high cholesterol;

hypertension, coronary artery disease, heart rhythm disturbances;

progressive cerebrovascular accidents;

pathologies of intervertebral discs of the cervical region;

diabetes mellitus

Doppler ultrasound is recommended for preventive purposes after 40-45 years. And also for smokers with many years of experience and persons with a family history of hypertension, coronary heart disease, strokes, and heart attacks.

Preparation and performance of ultrasound examination of vessels

There is no need to prepare specially for Doppler ultrasound. However, it is recommended to stop taking medications (including antispasmodics, drugs for cardiovascular diseases) on the day of the examination with the permission of the attending physician. You should also not smoke or drink alcohol; you should limit your consumption of coffee and other stimulating drinks. It is recommended to come to an ultrasound examination in comfortable clothes that do not put pressure on your neck and shoulders.

To carry out the diagnosis, the patient lies down on the couch. The doctor applies an acoustic gel to the neck area, which ensures the best passage of ultrasonic waves. During ultrasound examination of blood vessels, the doctor may ask you to turn your head, breathe deeply or quickly, and hold your breath for a few seconds.

The study takes about 20 minutes. Does not cause discomfort and is absolutely safe.

What does an ultrasound scan of the vessels of the neck show?

The results of duplex scanning are the following data:

the highest and lowest blood flow speed;
features of blood circulation in the vascular bed of the head and neck;
the relationship between systolic and diastolic blood flow velocity;
resistivity index, etc.

Doppler ultrasound of the neck vessels can be performed at the LEKON medical center. Diagnostics are carried out using the SonoAce-8000 Ex device. The results are interpreted by an experienced specialist. With the conclusion, you can contact your attending physician in Moscow or see our doctors (neurologist, cardiologist).

Our specialists