From this article you will learn: how to check the vessels of the whole body, what methods are used to obtain images of arteries and veins and to identify their diseases. Preparation for the survey and its conduct.
Contents of the article:
- Ultrasound examination methods
- Angiography
Healthy blood vessels are a guarantee of good blood supply to all human organs and a necessary condition for their normal functioning. That is why a large number of survey methods have been developed and put into practice, with the help of which it is possible to determine their diameter, to locate the sites of constriction and to evaluate the blood flow to the organs.
Applied methods allow to examine all the vessels of the body, however in clinical practice this is not done. It should be understood that any diagnostic method, even the most effective and safe, has its limitations and the price of the exercise. Therefore, doctors prescribe examination of only those vessels that are suspected of developing a particular disease.
It is the localization of the affected vessel and the type of disease that determines the choice of the diagnostic method used. Most often, such examinations are used to diagnose peripheral arterial diseases( obliterating atherosclerosis, endarteritis), cerebrovascular diseases( strokes), deep vein thrombosis, chronic venous insufficiency, diseases of the renal and coronary arteries, aortic aneurysm.
Aortic aneurysm is a pathological dilatation of the aortic lumen that can reach large dimensions and eventually lead to rupture of the vessel. All instrumental examinations of the vascular system can be divided into two groups:
- Non-invasive( without compromising the integrity of the skin).These are different types of ultrasound diagnostics.
- Invasive( with violation of the integrity of the skin).These are different types of angiography, in which a contrast agent is injected into the vascular bed.
Depending on the method used and localization, the examination is performed by physicians of functional diagnostics, cardiosurgeons, vascular surgeons. To appoint such examination the doctor of any specialty can.
Ultrasound examination methods
The essence of the study
Ultrasound( ultrasound) is one of the most frequent methods of examining blood vessels of different locations. To obtain images of arteries and veins, as well as blood flow estimates, ultra-high frequency sound waves are used.
Ultrasound can be used to examine vessels in almost all parts of the body, including the arteries and veins of the neck, abdomen, upper and lower extremities. Unlike other imaging methods, ultrasound does not use X-ray therapy or the administration of contrast media.
During ultrasound, sound waves penetrate tissues into the area under examination. They are reflected from the blood cells moving along the vascular bed and return to the sensor. These waves are recorded and displayed on the screen of the ultrasound machine, creating a picture of a blood vessel. The rate of their return allows you to determine the rate of blood flow in the artery or vein. If the blood flows too fast, this indicates a possible narrowing of the vessel.
Ultrasound is a non-invasive and painless procedure with no side effects and complications.
Which vessels are checked most often
Most often conducted:
- of peripheral artery ultrasound - for diagnosis of obliterating atherosclerosis and endarteritis.
- Carotid artery ultrasound - to detect narrowing in the largest vessels of the neck, which supply blood to the brain.
- US of renal arteries - for evaluation of blood flow in the kidneys and detection of constriction in their vessels.
- Ultrasound of the vessels of the abdominal cavity is a method of studying the circulation of blood through the veins and arteries of the stomach, intestine, liver, pancreas and spleen.
- Transcranial ultrasound of cerebral vessels - helps to measure blood flow in the arteries of the brain.
- ultrasound veins - allows you to assess the blood flow in the veins in the legs and hands, to detect their thrombosis.
Carrying out ultrasound in the carotid artery Preparing for the
survey Usually carrying out an ultrasound does not require any special training:
- You can not smoke for several hours before the examination, as smoking leads to a narrowing of the vessels, which can affect the results of ultrasound.
- If a person is to be examined for stomach vessels, he can not eat anything 12 hours before the procedure.
- In addition to smoking, the results of ultrasound may be affected by obesity, heart rhythm disturbances, cardiovascular diseases.
How the procedure passes
Before you check the vascular system with ultrasound, a person needs to remove clothing so that the doctor can access the area of the body. Depending on the vessels studied, the examination can take place in the patient's recumbent, sitting or standing position.
A water-soluble gel is applied to the skin in the area of scanning, which improves the conductivity of ultrasonic waves. To the area under examination, the doctor presses the sensor, which directs ultrasonic waves to the arteries and veins. During the examination, the sensor is moved over the skin to get a clearer image. The received information is processed by the computer and displayed on the screen in the form of graphs and images that characterize the blood flow in the arteries or veins.
All examination takes 10-30 minutes. After its termination, wipe the gel from the skin, then the patient dresses. After the ultrasound, a person can immediately return to his daily activities.
Interpretation of results
The normal results of the examination indicate that the patient does not have a constriction or overlap in the vessels. The pathological nature of the blood flow may indicate:
- The presence of constriction or overlap in the arteries, which may be a consequence of atherosclerotic plaques.
- Presence of thrombi in veins or arteries.
- Poor blood circulation caused by vascular damage.
- Occlusion of veins.
- Spasm of the arteries.
- Thrombosis or overlap of artificial prosthetic vessels.
Angiography
The essence of the study
Angiography is a visualization technique, by which it is possible to obtain an image of the internal lumen of the blood vessels of various organs. Since blood vessels can not be seen during X-ray examination, a special contrast agent is introduced into their lumen.
Types of angiography
There are 3 types of angiography:
- Traditional angiography - visualization of vessels after their contrasting is performed using fluoroscopy.
- CT angiography - visualization after contrasting is performed using computed tomography.
- MRI-angiography - the image is obtained using magnetic resonance imaging.
Angiography can also include venography - X-ray contrast examination of venous vessels.
Venereal cranial veins in a child What diseases can be detected with angiography
Angiography is used to identify various problems with arteries or veins, including:
- Atherosclerosis( narrowing of the arteries), which can increase the risk of stroke or myocardial infarction.
- Obliterating diseases of peripheral arteries, in which the circulation of blood in the legs worsens.
- Brain aneurysms - protrusion in the wall of the blood vessels of the brain.
- Thromboembolism of the pulmonary artery is a dangerous disease in which clots enter blood vessels into the lungs.
- Stenosis( constriction) of the renal arteries.
Angiography helps:
- Determine the severity and precise localization of the narrowing or overlapping of blood vessels.
- Determine the localization of the source of bleeding, and when combined with embolization - stop it.
- Reveal and remove the blood clot in a sealed vessel and restore blood flow.
- In combination with embolization - treat certain types of tumors by stopping their blood supply.
- Create a blood vessel map before surgery.
Based on the accuracy of the results obtained, angiography is the gold standard among all diagnostic methods for examining the circulatory system. With its help, you can identify the slightest changes in the structure of the arteries and veins, revealing the problem at the initial stages of development.
Preparing for
procedure Basic recommendations for angiography preparation:
- Before some types of angiography, you should not eat anything 4 to 6 hours before the examination.
- Bring to the procedure all results of previous blood vessel examinations, so that doctors can compare them with new data.
- Before the examination, ask all your questions to medical personnel.
- If you have kidney disease or diabetes mellitus, there have been allergic reactions to contrast agents or other drugs, be sure to tell the doctor about it.
- If you are taking metformin, aspirin, clopidogrel, warfarin, or other blood-thinning medications, tell your health care provider.
- If the angiography is performed on an outpatient basis, arrange with a relative or friend to take you home after the examination. Sometimes, angiography introduces sedatives that can make you drowsy.
Before the examination, the patient is asked to change into surgical underwear, he is given a mild sedative that helps to relax. Sometimes angiography is performed under general anesthesia.
Angiography of the heart or coronary angiography. In addition to the femoral artery, the catheter can also be inserted into the radial artery on the arm of the . As the procedure passes
. During the examination, the patient lies on a special table in the operating room, equipped with special X-ray instruments. Medical personnel conducts monitoring of cardiac activity, respiration, blood pressure and oxygen levels in the blood.
The site of the vascular access( usually the right inguinal region) through which a special catheter is inserted is treated with an antiseptic solution and covered with sterile underwear to minimize the risk of infectious complications. This area is anesthetized with a local anesthetic, after which a thin catheter is inserted into the lumen of the vessel. Then the doctor under the control of fluoroscopy turns this catheter into the test vessels and injects a contrast agent with simultaneous fluoroscopy. The resulting image of the internal structure of the vessels is displayed on the monitor. At the time of contrast, the patient can feel a rush of heat throughout the body.
Vascular testing with angiography may take from 30 minutes to 2 hours. After completion of the examination, the doctor removes the catheter from the vessel and presses the injection site for 10 minutes to stop possible bleeding, and then applies a sterile bandage. If vascular access was through the femoral artery in the groin, the patient after the examination should lie with his legs straightened for about 4 hours. After the procedure, you can eat and drink.
Possible complications after angiography
Most patients after angiography have a bruise at the site of vascular access and feel soreness in this place when touching or moving. These problems disappear after a few days.
Possible complications of angiography:
- An infectious process in the place of vascular access, which is manifested by the redness, soreness and swelling of this area.
- An unhealthy reaction to contrast - for example, a skin rash.
- Kidney damage with contrast agent.
- Damage to blood vessels, leading to internal bleeding.
- Severe allergic reactions to contrast, causing a drop in blood pressure, difficulty breathing, or loss of consciousness.
