Duplex scanning of the cervical spine. Diseases detected by duplex scanning

If a person is tormented by frequent headaches and migraines, it happens that the nose bleeds, vision deteriorates, mental work becomes difficult, then it is time for him to go to the clinic for an appropriate examination. Today, angiosurgeons and neuropathologists constantly use ultrasound diagnostic methods, because this will allow you to quickly, inexpensively and without the slightest injury to study the state of veins and arteries, and the information obtained during the study is highly informative.

This article will discuss what ultrasound of the vessels of the head and neck shows, what are its varieties.

Features of the procedure

Examination of the vessels of the head and neck is a combination of ultrasound and Doppler into a single diagnostic technique. This ensures that the study allows you to simultaneously examine both the morphology and anatomy of the vessels (inside and outside), and observe the features of blood flow.

Ultrasonic waves bounce off veins and arteries, as well as moving blood cells, and are then analyzed by a computer program. As a result, a dynamic image is obtained, from which a photo can be taken at any time, thus, doctors receive a complete visualization of the state of the object under study. At the same time, a color picture is displayed on the monitor, which greatly facilitates the diagnosis (arteries are indicated in red, veins are indicated in blue).

Ultrasound dopplerography, depending on the objects examined, can be of two directions:

transcranial or examination of cerebral vessels;
brachiocephalic vessels - study of the state of the vessels of the neck.

When examining the head, it is impossible to do without diagnosing the underlying veins and arteries, since they nourish the tissues of the neuroglia.

Note. In addition to the above imaging methods, there is another type of Doppler ultrasound - MAG ultrasound, which is a screening of the main arteries of the head.

Depending on the specific purpose or indications, the patient may be prescribed the following types of examination of the vessels of the brain and neck, for which various approaches and equipment are used:

dopplerography– designed to determine the features of blood flow;
ultrasound duplex scanning- gives an idea of the anatomical structures and at the same time allows you to measure the speed of blood movement;
triplex- helps to find out the details of the structure of veins and arteries, their patency, while the visual display also has a certain color scheme.

All the methods listed in the article and on the video, when detecting anomalies, allow you to capture a picture on the screen, take screenshots, then print them out or save them digitally, so ultrasound of the vessels of the head and neck is of great importance for further monitoring the state of human health.

Note. If a person has minor deviations from the norm, then this is an indicator that he needs to undergo regular medical examinations and duplex ultrasound of the vessels of the neck and head, since slight deviations in blood flow can cause serious neurological problems in the future. Ultrasound techniques are safe and inexpensive, making them reusable.

What shows

Ultrasound of the vessels of the brain and neck visualizes the location of stenosis, the presence of reflux (reverse blood flow due to disruption of the valves), the speed and direction of blood flow, separation or thickening of the walls, which indicates the progression of the hypertensive process. plaques can accumulate on the endothelium, as well as blood clots, which pose a significant threat to human life.

A change in the nature of the blood flow can be the cause of aneurysms. Such tap examinations are important in the presence of problems with the blood supply to the brain, because if the problem is identified in a timely manner and appropriate therapy is initiated, it is likely that a stroke will be avoided.

Indications for ultrasound of the vessels of the brain

Ultrasound examination of the brain is recommended in the following cases:

dizziness, pain, noise in the head;
mental disorders: memory loss, difficulty concentrating, and others;
nosebleeds of different frequency;
atherosclerosis and high cholesterol levels (read more);
VSD, regardless of type;
disorders of cerebral circulation of any nature;
neck and head injuries with damage to internal organs;
ischemic processes in brain tissues for various reasons;
a history of complex diseases: diabetes mellitus, cerebral hemorrhage, myocardial infarction.

Duplex ultrasound scanning of the vessels of the neck and brain is indicated for:

disruption of the central nervous system with characteristic symptoms: mental disorders, convulsions, dizziness, migraines and others;
craniocerebral injuries;
a tumor process of any quality, if the neoplasms squeeze the arteries;
after surgical treatment;
suspicion of the formation of blood clots or cholesterol deposits;
deformations of vessels of any nature, for example, a change in their diameter, caused by various pathologies, including the inflammatory process.
arteriovenous malformation of the brain

Establishing an accurate diagnosis allows doctors to select the appropriate treatment, increase the effectiveness of the latter, make short-term and long-term forecasts, and track the dynamics of the patient's health.

Ultrasound and duplex scanning of the vessels of the neck and head are indicated for people suffering from such diseases:

hypertension, ischemia of the heart and brain, heart rate disturbances;
problems of cerebral circulation, after a stroke;
diabetes;
genetic prerequisites for the development of vascular diseases;
progressive atherosclerosis or high cholesterol levels in a blood test;
problems with the cervical spine, causing headaches.

Examinations are also indicated for heavy smokers and during preventive examinations of persons over 45 years of age.

Note. All types of Doppler ultrasound of the vessels of the neck and head can be performed for patients of any age category.

Preparation and progress

In this case, special specific preparation for ultrasound is not required, but there is a certain instruction that imposes some restrictions. Pay attention to the table, which indicates what can not be done on the eve of the examination.

Restrictions	Comment	A photo
Antispasmodics	In order for the ultrasound indicators of the cerebral vessels not to distort the result 24 hours before the ultrasound, you should not take drugs that affect the morphology of the vessels (Drotaverin, Baralgetas, No-Shpalgin, etc.).
Some medicines	It is not necessary to drink medications a day before the examination that affect cerebral circulation: calcium channel blockers (Fezam), psychostimulants (Cavinton, Vicebrol) and others.
Drinks with caffeine and ethanol	Alcohol and caffeine cause spasms and relaxation of blood vessels, so they should not be consumed before the examination.
Smoking	Tobacco smoke contains substances that cause a short-term spasm of the veins and arteries, so a few hours before the ultrasound scan, you should refrain from smoking.

Important. If a person cannot refuse to use the drug on the eve of the study, then it is necessary to inform the doctor about the drug taken, who conducts the diagnosis and deciphers the analysis.

The examination does not take long and without discomfort. The patient should have a towel and wet wipes with him (to wipe off the remnants of the gel).

During the examination, the patient lies, and an analyzer is applied to his neck or head, emitting ultrasound, which he also reads. The doctor sees the received images of the vessels on the monitor and makes the necessary notes or pictures.

As a rule, a nurse or laboratory assistant is nearby to help record the results. There is no pain during the procedure. The clinician can press on the vessels, ask to hold or speed up breathing, change the position of the head. The examination lasts from 15 to 30 minutes on average, depending on the complexity of the pathologies.

Conclusion

The use of duplex scanning and ultrasound of the vessels of the head and neck with the use of Doppler allows you to get an idea not only about the state of their walls, but also to examine the level of blood flow, its dynamics, speed and direction. In addition, the examination helps to establish the causes of the pathological process and help doctors in choosing a therapeutic technique. The advantages of the study are low cost, availability, simplicity, non-invasiveness and short duration. There are no contraindications.

Vascular ultrasound- a study that displays the structure and characteristics of blood flow in peripheral and main vessels, in arteries and veins located in internal organs. Doppler ultrasound 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. The cost of ultrasound depends on the chosen method and the volume of examinations.

Training

Mandatory preparation for ultrasound of the vessels is not required. If a study of the abdominal aorta is performed, it is recommended to stop eating foods that provoke flatulence for 3 days. It is worth excluding legumes, pastries, confectionery and carbonated drinks from the menu, and reducing the amount of fresh fruits and vegetables. The procedure is best done after 8-12 hours of fasting. To obtain informative results of the study of 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

Doppler ultrasound allows you to assess the patency of the vessel, determine the direction, speed of blood flow. There is no visualization of the vessels; in case of deviations from the norm, it is impossible to clarify the cause. 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 the vessels. Ultrasound signs of atherosclerosis are a decrease in the elasticity and elasticity of the vessel, a thickening of the intima media layer, a change in the uniformity of blood flow, and 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. High blood pressure can be the result of atherosclerosis (plaques are found), stenosis (narrowing of the lumen is recorded), and circulatory failure of the kidneys. The characteristic features of the ultrasound picture are thickening of the walls of the arteries, an increase in the speed of the pulse wave from the carotid to the femoral artery up to 12 m/s or more, the ABI is less than 0.9.
Violation of cerebral circulation. Circulatory disorders 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 lumen of the vessels.
Phlebeurysm. The ultrasound method allows you to determine the cause of varicose veins, to assess the degree of blood flow disturbance. An uneven expansion of the vascular lumen, a change in the trajectory of superficial veins, hyperechogenicity of the walls, insufficiency of the valvular apparatus are diagnosed.
Thrombophlebitis and deep vein thrombosis. In patients with thrombophlebitis, inflammatory changes and thrombi of the saphenous veins are found. In deep vessel thrombosis, the nature of the thrombus is determined. A floating thrombus is characterized by tip mobility, heterogeneous echostructure, and uneven surface. Embologenicity is higher with reduced echogenicity or anechoic clot. An occlusive thrombus causes blockage of the vessel, parietal - locally reduces the blood flow velocity.

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

Advantages

Compared to X-ray angiography, CT and MRI of blood vessels, sonographic methods for studying blood vessels are more accessible, allow you to quickly get the result, 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 studying small vessels. Ultrasound of the vessels has become widespread due to its non-invasiveness and low cost.

Thanks to the vascular system, blood rich in oxygen and nutrients is delivered to all parts of the body. If important arteries connecting the aorta to the lower extremities, as well as peripheral blood vessels, are blocked or modified, then the person begins to experience serious consequences of impaired blood supply to the legs.

In the diagnosis of vascular diseases, ultrasound does not lose its relevance. In particular, duplex scanning of the veins of the lower extremities is very popular. Having appeared for the first time at an appointment with a phlebologist or an angiosurgeon, the patient may hear many terms unfamiliar to himself. So, for example, he may not know what an ultrasound of the veins or duplex scanning of the vessels of the lower extremities is.

Leg doppler options

Vascular Doppler ultrasound is a way to study blood flow in the large and medium veins and arteries of the human body. The essence of the technique is related to the Doppler effect, which implies that ultrasonic waves reflected from moving objects will change frequency in proportion to the speed of these objects.

Dopplerography of the vessels of the lower extremities is divided into 3 main types:

Ultrasound of the vessels of the lower extremities is an outdated ultrasound diagnostic, which is used less and less. This is due to the fact that devices have appeared that allow for research at a higher level. Previously, this method was widely used to assess the patency of veins and the viability of valves in various groups of vessels.
Duplex scanning of the vessels of the legs (USDS) is a method based on the use of color Doppler echography. Unlike ultrasound of the lower extremities, this method reveals not only the main indicators of hemodynamics, but also structural changes in the walls of blood vessels.
Ultrasound with color mapping (triplex scanning) is a modern method using pulsed Doppler, which allows you to evaluate blood flow in any part of the vascular bed in real time and give a color (blue and red shades) designation of its speed. The richer the shade, the faster the speed. The advantage of triplex is the ability to simultaneously assess the state of the vessel in three ultrasound modes, while duplex scanning uses only two modes.

Violation of the valve function leads to the appearance of the opposite direction of blood flow in the direct and indirect communicating veins.

Indications and contraindications

Ultrasound of the vessels of the lower extremities has the following main goals:

determination of the patency of venous vessels of various significance and level of localization;
diagnosis of insolvency of vascular valves;
assessment of insolvency of perforating veins.

persistent and dense swelling of the ankle area;
conspicuous dilated saphenous veins;
brown or purple-pink spots on the skin of the legs;
weeping wounds and suppuration on the leg;
temporary loss of sensation in the legs, frequent paroxysmal involuntary muscle contractions;
severe itching without dermatological pathologies.

endocrine diseases;
elevated blood cholesterol
long history of smoking;
pain in the limbs with increased walking;
pallor of the skin on the legs;
rapidly freezing limbs;
muscle weakness in the legs;
temporary loss of sensation and undulating tingling in the legs.

Ultrasound of the extremities allows you to diagnose such diseases: atherosclerosis of the vessels, the formation of blood clots in the lower leg, thigh or pelvis, endarteritis (chronic inflammatory disease) obliterating, varicose veins.

Ultrasound duplex scanning of the extremities allows you to evaluate the following characteristics of the vascular system:

what condition are the vascular walls in;
how passable deep and superficial veins;
valvular insufficiency;
the presence of blood clots and associated pathologies;
the reason for the resumption of varicose veins after adequate therapy.

Duplex scanning of the arteries of the lower extremities is necessary in such cases:

feet freeze even in warm weather;
frequent soreness in the lower extremities associated with walking;
pain in the legs at night, which is relieved by lowering the limbs from the bed;
long-term smoking;
elevated blood cholesterol levels, diabetes mellitus.

Duplex scanning of the veins of the lower extremities is recommended in such cases:

the risk of developing hereditary varicose veins;
the need to exclude blood clots before abdominal surgery;
accumulation of fluid in the tissues of the lower extremities;
pain in the legs of a bursting character;
darkening and cyanosis of the skin on the legs from the knee to the feet;
weeping and non-healing wounds on the legs.

Examination of arteries and veins is not performed on patients who are in a general serious condition, have burns or other dermatological problems, are observed by a psychiatrist.

Acoustic gel is applied to the area to be examined prior to screening.

Carrying out the procedure

The study begins with the inferior vena cava. At this stage, it is important to exclude the presence of a thrombus and prove the patency of the external and internal (if visualized) iliac veins. Next, the common femoral vein, superficial and deep femoral vein, popliteal, anterior and posterior peroneal and tibial veins, as well as superficial vessels are examined.

Ultrasound of the veins of the lower extremities is performed as follows:

First, the patient is examined in a horizontal position, and then in a vertical position.
A Valsalva test is performed with standard expiratory pressure and a test with compression of the proximal sections. When the patient holds his breath while inhaling, the pressure in the peritoneum rises and thus creates a good test situation to check the operation of the valves of the deep and superficial veins.
A respiratory and cough test is performed. In this case, the patient should take the deepest possible breath or simulate a cough several times. Such movements should lead to the appearance of an opposite blood flow if there is a pathology of the valvular apparatus.

Dopplerography of the deep veins of the lower extremities is performed in color and gray modes. In addition, in the process of ultrasound of the arteries, it is necessary to measure blood pressure in different parts of the limb. For this, special cuffs are used. The study is carried out in a horizontal and vertical position with a selection of ultrasound frequencies depending on the localization of the vessel.

The duration of the procedure is 40 minutes. If it is performed by a phlebologist, then immediately after the examination, he can choose the appropriate treatment tactics. In this matter, everything is very individual, and sometimes the results of the diagnosis can vary greatly depending on which specialist conducted it.

Deciphering the results

With ultrasound of the veins of the lower extremities, the decoding of the results includes the following parameters:

bilateral vein assessment;
reaction to breath tests;
reaction to compression by the sensor;
characteristics of the vascular wall (elasticity, rigidity, thickening);
the presence of blood clots in the lumen of blood vessels;
consistency of valves;
pathological venous refluxes;
location of incompetent communicating veins.

If plaques are found in the vessel, then they describe their location, how many substances they consist of, how mobile they are, and whether there are complications.

In order to better examine the veins, pressure on the area of their localization with different intensity is also added to the samples with straining.

If they do an examination of the arteries of the legs, then in the transcript they describe the following indicators:

the structure of the vessel and the thickness of its wall;
characteristics and type of blood flow in each artery;
blood flow velocity, including peak systolic for each artery;
Gosling index;
resistive index;
IMT value (intima-media complex);
percentage of stenosis (narrowing) of the artery.

Where to make a Doppler diagnosis of veins and arteries for a patient is better to ask your phlebologist or angiosurgeon. They can recommend a trusted place. As a rule, on a first-come, first-served basis, such an examination can be done free of charge at the vascular surgery departments of a public hospital.

But if you don’t want to wait and your financial situation allows, then the study can be done for a fee at the nearest phlebological clinic or diagnostic center. In this case, it is important to ensure the good reputation of this medical institution and the high qualification of the staff.

Ultrasound of the vessels of the legs is a comfortable and safe diagnostic for the patient, which can be prescribed in any age category. It does not require special preparation and after 60 minutes you can get a detailed idea of the functioning of your vascular system.

Medicine is constantly presenting to society new methods for diagnosing serious pathologies. The success of the treatment of various diseases depends on their timely detection, the appointment of the necessary therapy. Duplex scanning of the vessels of the head and neck is an innovative research method that allows you to see in a two-dimensional projection the smallest tubular hollow formations of the human body. The non-invasive nature of the technique facilitates the procedure, does not require recovery after the manipulation.

What is duplex vascular scanning

How to check the head in a non-invasive way? The unique properties of ultrasound help it pass through the tissues of the human body and, reflecting from blood cells, send a signal in the form of an image of the area under study to the screen of the diagnostician's monitor. Through duplex scanning of the vessels of the head and neck, a specialist can evaluate blood hemodynamic parameters, obtain information about the anatomical features of the veins and arteries. Different Doppler technologies use the properties of the sound wave in the same way, but have different functionality:

UZDG (ultrasound dopplerography). This study helps to assess the patency of the vessels of the brain, neck, and other organs. UZDG carries only one functional load - the determination of hemodynamics.
Duplex ultrasound scanning. Using this method, it is possible to diagnose the presence of atherosclerotic plaques, blood clots in the arteries and veins, contributing to the narrowing of the lumen of the vessels. During monitoring, a tubular formation with surrounding tissues is visualized. Duplex scanning is divided into the following subspecies:

extracranial - examines the main vessels;
intracranial - checks intracerebral "pools";
transcranial - provides color duplex scanning of the brain.

triplex scanning. Dopplerography of the vessels of the head and neck, during which, in addition to information about the intensity of blood movement, the diagnostician receives a color image of a tubular formation with surrounding tissues.
Ultrasound procedure. Shows the "big picture" of the structure of arteries and veins. Doppler ultrasound helps to find out the characteristics of the movement of blood flow, to conduct an examination for the presence of pathologies.

Indications for the appointment of the study

Examination of vessels of a planned nature should be carried out without fail once a year. Detection of an anomaly at an early stage of development helps to avoid the negative consequences associated with a progressive form of the disease and take measures to prescribe the necessary therapy. Duplex scanning of the patency of the vessels of the head and neck is often prescribed to verify the results obtained during the implementation of MRI, ultrasound of the vessels of the neck and head. Indications for a duplex are the following symptoms:

headache;
dizziness;
fainting;
hand numbness;
lack of coordination;
memory loss;
smoking;
a history of stroke;
cervical osteochondrosis;
arterial hypertension;
previously identified vascular dystonia;
family ties with hypertensive or diabetic;
vasculitis (inflammation of blood vessels).

How to prepare

Examination of the head and neck does not require special preparation from the patient. On the day of the procedure, it is necessary to abandon the use of drugs that increase vascular tone: coffee, nicotine, tea, energy drinks. Cancellation of drugs that can distort the results of ultrasound - "Betaserk", "Cinnazirin" - requires consultation with a neurologist. Before scanning, the patient will need to remove all foreign objects in the form of chains, hairpins, etc. from the area under study.

How is the procedure carried out

Duplex scanning can be done in the direction of the attending physician in the neurological departments of large city hospitals or go to the clinic according to the area of residence. Manipulation is carried out according to the general rule. The patient is placed on the couch, a hard pillow or roller is placed under the head, the head is taken away to the side opposite to the sensor.

Before starting the procedure, the doctor applies a little special gel to the area under study, with which you can easily “drive” the transducer over the surface of the skin, analyzing the arterial and venous channels. The vessels of the brain are checked through the bones of the skull. Previously, the skin is treated with a water-soluble gel, then the doctor places sensors on the following areas:

temples;
above the eye sockets;
alignment of the occipital bone with the spine;
occipital bone.

Deciphering the results

Upon completion of the examination, the doctor receives comprehensive information about the condition of the arteries and veins. The analysis of the venous bed practically does not contain digital data, but includes the following parameters:

anatomy;
patency;
the speed of blood movement;
the presence of abnormal formations inside the lumen.

Dopplerography of arterial vessels collects digital data that are compared with normal values. The presence of the following indicators can be considered a satisfactory condition of the common and carotid arteries:

the limiting speed of blood movement in the artery is less than 0.9;
percentage of stenosis - 0;
peak speed in diastole - less than 0.5;
absence of formations inside the lumen;
wall thickness - 0.9-1.1.

Are there any contraindications

The advantage of duplex scanning is the absence of a negative effect on the human body. The non-invasive nature of the study helps to diagnose blood vessels in an adult and a child without any restrictions. Relative contraindications can be considered a serious condition of the patient or the presence of diseases that prevent the patient from moving to a horizontal position.

Video: what ultrasound of the vessels of the head and neck shows

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

Duplex scanning of the vessels of the head and neck is a modern technique for studying brachycephalic vessels using ultrasound - large venous and arterial highways that supply blood to the brain, head and hands. These vessels separate from the aorta at the shoulders.

Duplex scanning offers an improved approach to replace Doppler ultrasound. In fact, the study combines Dopplerography (the study of the properties of blood flow) and B-mode - the ability to "see" the state of the vascular walls and adjacent tissues on the monitor.

The procedure makes it possible to identify:

Scanning allows you to evaluate:

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

With the help of ultrasound, you can diagnose:

the presence of anatomical features or anomalies;
atherosclerosis - the detection of atherosclerotic plaques in the brachycephalic arteries is one of the main tasks of the procedure;
traumatic damage to venous or arterial lines;
inflammation of the walls - large vessels (arteries) or small ones (capillaries);
angiopathy (violations of the structure of capillaries, up to a significant narrowing or blockage) - diabetic, hypertensive or toxic nature;
dyscirculatory encephalopathy - brain damage against the background of a slowly developing cerebrovascular accident;
vegetovascular 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 combination 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 the nutrition of the brain).

Based on this principle, ultrasound is distinguished:

extracranial departments of the vessels of the head and neck - assessment of the state 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 more often contain atherosclerotic changes;
intracranial(transcranial) sections of the vessels of the head and neck - scanning of arteries and veins located inside the skull (Vellisian circle and cerebral arteries). It is recommended in situations where the first type of study has not yielded results, and symptoms of impaired cerebral circulation are present. The examination has a number of features, one of them is due to the fact that a special frequency of the ultrasonic wave 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.

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

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

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. Both triplex and duplex should be distinguished from Doppler ultrasonography. Ultrasound does not provide visualization of the vessel, all information is given in the form of graphs. Curves can only indicate anomalies in blood flow and suggest a cause (thrombus, narrowing, rupture).

In addition, during ultrasonography, the sensor is applied by the “blind” method, approximately in those places where the vessels should be projected.

Duplex and triplex involve imaging - like any ultrasound examination. By looking at the monitor, the diagnostician can track the position of the sensor and visually evaluate 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 investigated (functions)	Vessels are evaluated according to two (duplex) criteria - the structure and the level of blood flow.	"Duplex" functions are performed - visualization of the structure and assessment of blood flow. A third (triplex) opportunity is added to "see" the movement of blood through the vessel in color mode and more accurately diagnose patency disorders.
Received 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 easier and more accurate to track wall thickness abnormalities or obstructions in blood flow.
Price	Cheaper	Expensive

From the point of view of diagnostics, 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, in terms of information content, the procedures differ slightly - to a greater extent, the accuracy of diagnostics is affected by the quality of the equipment used and the experience of the medical specialist.

Indications for research

Duplex scanning of the vessels of the head and neck is carried out when characteristic symptoms appear or the presence of confirmed diagnoses, the person belongs to the "risk group".

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

vascular endarteritis (an inflammatory process that develops in the tissues of the vascular wall and is accompanied by their narrowing);
atherosclerosis - the deposition of cholesterol and complex proteins in the lumen of the vascular highways;
traumatic damage to blood vessels;
aortic aneurysm - an expansion of a section of the main artery against the background of a weakening of the tone of its wall;
thrombosis and thrombophlebitis - the occurrence of blood clots inside the vessel, including accompanied by inflammation;
vasculitis - inflammation of the vessels of an autoimmune nature, when functional cells are attacked by a person's own immune system;
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 the vessels;
vegetovascular dystonia;
post-infarction and post-stroke periods;
preparation for surgical manipulations on the heart;
the period of rehabilitation 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 much more informative than dopplerography.

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

Procedure Evaluation Criteria	Deciphering the criterion for USDS	Pros and cons
informative	High	+
Holding speed	The study takes up to 40 minutes	+
Safety	The procedure can be performed in any condition of the patient	+
Presence of contraindications	Information content may decrease in the presence of calcified deposits.	+
Pain and invasiveness	Absent, the procedure can be carried out repeatedly (unlike an X-ray study, for example). Ultrasound does not threaten any complications	+
The need for special training	Specialized preparatory procedures are not required	+
Ability to write results to media	It is impossible to print a visual picture, the vessels are assessed only during ultrasound, “here and now”	—
Dependence on the human factor and technical equipment	Significant	—
Price	Examination is more expensive in comparison with Doppler ultrasound	—
Availability	The procedure requires modern equipment and qualified personnel - ultrasound 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 use of drinks and drugs that affect blood circulation and vascular tone.

If the patient is taking drugs that affect vascular tone or reduce pressure, it is necessary to check with the doctor in advance which of them need to be canceled.

How is the procedure carried out

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

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

left and right temple;
the 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 it will be necessary to remove the remains of the gel from the skin and hair.

Deciphering the results

You can usually get the result within a few minutes after the ultrasound. The result is a printout containing a list of examined vessels with a description, it also reflects the presence of anatomical anomalies.

The description of the state of the artery includes the listing of the following indicators:

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

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

Normal values are different 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
Speed 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 constrictions (0% stenosis), thickening or plaques, and the blood should move freely without the phenomena of turbulent flow (vortices).

Among the common deviations from the normal characteristics of the vessels:

stenosis- the lumen is narrowed, the 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;
violation of vascular tone with vegetovascular dystonia;
vasculitis- thickened in a long area or exfoliating wall.

Ultrasound of the veins contains fewer digital indicators, here it is estimated:

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

Are there any contraindications

Vessel duplex is safe, during the procedure there is no discomfort, there is no negative effect on the body. There are no age or other restrictions on the examination. The presence of atherosclerotic deposits with a high level of calcification, a process when calcium salts settle on top of a cholesterol plaque, can distort the results.

Where to get the procedure

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

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

The price is made up of a combination of the following factors:

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

Duplex scanning of the state of the vessels of the neck and head is a modern non-invasive procedure that allows for 40 minutes to obtain comprehensive data on the state of the arterial and venous highways 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 belonging to risk groups help to reduce the likelihood of developing acute cerebrovascular accidents.

Article formatting: Lozinsky Oleg

Video about duplex scanning of vessels

What is this procedure and what is it used for: