UZDG vessels of the head, brain and neck: features and research possibilities

Ultrasound diagnosis is one of the safest and most effective methods for detecting various diseases and pathologies of internal organs.

It is used in various fields of medicine, including for assessing the condition and possible disorders of the body's vascular system.

In this case, a study called UZDG, or dopplerography, which examines the vessels of the neck and brain.

Ultrasonic dopplerography - what is it?

The technique is based on the use of ultrasound with the Doppler effect - in other words, ultrasonic waves reflected from blood cells, displays on the screen of the device the image of blood vessels.

Depending on what veins and arteries need to be examined, the study can be carried out in two ways:

• Transcranial ultrasound- The sensor of the device is installed on the skull bones where they have the smallest thickness, which allows an assessment of the condition of veins and arteries located directly in the brain;
• Dopplerography of extracranial vessels- The method is used to inspect large vessels passing through the neck (jugular veins, carotid, vertebral and subclavian arteries).

Indications and contraindications

The indications for the study include:

• neurological symptoms, which can talk about brain power abnormalities (dizziness, impaired coordination, tinnitus, insomnia, etc.);
• heart rhythm disturbances;
• presence of factors that increase the risk of development (elevated blood cholesterol, intense smoking, excess weight, etc.), or the first signs of cerebral artery atherosclerosis;
• chronic hypertension;
• transient ischemic attack;
• vegetovascular dystonia;
• stroke or history of a heart attack;
• diabetes;
• osteochondrosis of cervical department;
• planned heart surgery;
• pulsating formations in the neck region;
• thrombosis of veins and arteries;
• vascular disorders (stenosis, atherosclerosis, aneurysms);
• increased fatigue;
• scoliosis and mental development disorders in children.

In this video, the details are given of the indications and procedure:

Preparation of the procedure

Special preparation for the USDG study is not required. The only thing a patient needs isAvoid smoking, alcohol and taking vascular medications on the eve of the procedure, since a change in the tone of the vessels can affect the accuracy of the result.

During the dopplerography, the patient lies on his back, and the doctor applies a special gel on certain areas and conducts an ultrasonic sensor through them.

During the procedureyou may need to breathe more often, hold your breath or turn your head in a certain way. In this case, a person does not experience any painful sensations, and the only thing that can bring a small discomfort - a slight depression on the neck or head.

UZDG extracranial vesselsbegins with scanning the lower segment of the common carotid artery from the right side, after which the sensor is moved up the neck to the angle of the lower jaw.

This allows you to assess the course and depth of the artery, determine the place where it is divided into internal and external, as well as identify atherosclerotic plaques.

After thatthe machine switches to color modeto examine the area for the presence of sites with disturbed blood flow, anomalies in the structure of the vascular walls, thrombi or plaques.

Then the vertebral arteries are inspected and the main diagnostic parameters (systolic and diastolic blood flow velocity, their ratio, etc.) are measured.

Transcranial ultrasound-dopplerographyvessels of the brain and neck is carried out through the front and middle temporal windows located respectively in front of the auricle and above it. In this way, the main arteries of the brain (posterior, anterior, middle), the Galen and Rosenthal veins, the posterior connective artery and the straight sinus are visualized. To examine the eye artery and siphon the internal carotid sensor is installed in a closed eyelid.

What shows: principles of decoding results

During the procedurethe following indicators are evaluated:

• the thickness of the vessel wall and its diameter;
• the nature and phase of the blood flow, as well as its symmetry over the same arteries;
• minimal (diastolic) and maximum (systolic) blood flow velocity, as well as the ratio between them;
• pulse and resistive index.

Normally, on ultrasound of the vessels of the neck and head, the average values ​​are as follows:

• the thickness of the vessel wall should not exceed 0.9 mm, but in some cases values ​​from 0.9 to 1.1 mm are permissible;
• free from neoplasms and other obstructions lumen of blood vessels;
• absence of turbulent blood flow in those areas where there is no branching of blood vessels;
• absence of pathological vascular network (malformation);
• vertebral arteries should have the same diameter, which does not exceed 2 mm;
• the velocity of blood flow in the vertebral veins (up to the sixth vertebra) should not exceed 0.3 m / s;
• the vessels should be free of any external pressure - if signs of compression are observed, the patient may need additional research (they may indicate tumors and other pathologies).

Assess the state of some vessels (some small veins, as well as those located in hard-to-reach places) is difficult, so in such cases, the patientadditionally appointed angiography of cerebral vessels. In addition, the diagnostic value of the result depends to a large extent on the quality of the equipment and the professionalism of the physician.

Possible violations and diagnoses

• Stenosing atherosclerosis.

  In this disease, atherosclerotic plaques are observed in patients, and their features can tell whether they are able to become a source of embolism.

  In the early stages of atherosclerosis, when plaques are not yet present, it is fashionable to see an increase in the thickness of the intima-media complex in the image.

• Nonstaing atherosclerosis. Disturbances in the structure of large arteries, uneven changes in echogenicity, thickening of the vascular walls and narrowing of the lumen by 20% or less.
• Temporal arteritis. Expressed signs of a uniform diffuse thickening of the walls of the vessels, accompanied by a decrease in echogenicity. If the disease is in a neglected stage, atherosclerotic lesions are added to the above symptoms.
• Vasculitis. The result of ultrasound examination depends on the stage and spread of the pathological process. Usually vasculitis is manifested by diffuse changes in the walls of blood vessels, a violation of differentiation of layers, changes in echogenicity, and also signs of inflammation.
• Hypoplasia of vertebral arteries. Hypoplasia is a reduction in the diameter of the arteries to 2 mm or less. Violation can be accompanied by a defect from entering the canal of the transverse processes of the cervical vertebrae.
• Vascular malformation. In this case, the patient has an abnormal vascular network that can be of different sizes. The veins that depart from the site with pathology are strongly hypertrophied, have signs of calcification and liposome infiltrates. The consequence of malformations can be the so-called syndrome of "robbery" and a violation of the processes of cerebral circulation.

average cost

Ultrasound dopplerography of the vessels of the head and neck is one of the most accessible studies to date, which can be done in almost any diagnostic center both in Russia and abroad. In domestic clinics the procedure will costin 3-8 thousand. rubles, and in foreign its cost starts from 500 dollars.

In addition, it is very important to remember that decoding the result and diagnosingmust deal exclusively with a specialist.