Features and capabilities of duplex scanning of the vessels of the head and neck

Ultrasonic methods of diagnostics of various kinds of diseases are now widely spread due to their simplicity and high enough informativeness.

Ultrasound waves are subjected to both parenchymal organs( liver, pancreas, etc.) and large vascular bundles. And one of the methods for examining the arteries and veins of the neck and head region is duplex scanning.

What is this

Duplex scanning of the vessels of the head and neck( brachiocephalicbasin) is a modern ultrasound technique that combines the functionality of methods such as ultrasound dopplerography and ultrasound angiographyI .

The main feature of the duplex test is that the specialist during the procedure sees a picture of the state of the vessels at the moment

What is different from USDG

The UZDG study covers its functionality by measuring and assessing the state of blood flow in the vessels of the brachiocephalic zone, without affecting the visualization of the presence of immediate causes of obstructed blood flow.

Duplex study also additionally illuminates this side of the pathology of arteries and veins , showing and localizing atherosclerotic plaques and thrombotic masses on the inner surface of the vessels of the head and neck region, their morphological features and the prevalence of the process.

Such possibilities of the method are its undoubted merit, because the combination of ultrasound and angiography not only save time for diagnosis of the disease, but also give a wider picture of changes in the vessels.

What you can see

First of all, a duplex study of the head and brachiocephalic arteries and veins is prescribed to those patients who have suspicions of atherosclerotic processes, aneurysms and deformities and other pathologies, and is aimed at identifying functional and structural arteriovenous disorders.

Indications for prescribing

Vessels of the brachiocephalic region include intracranial( intracranial, directly nourishing the brain and surrounding tissues) and extracranial( extracranial, which capture the tissue of the neck, face, occiput, and the like).

In duplex scanning, an evaluation is made of both the first and the second group, which can be affected separately for different types of pathology and give appropriate indications for the study.

In general, this diagnostic procedure is shown to those people who have the following statuses:

• headaches;
• problems with remembering and mindfulness;
• dizziness;
• vestibular disorders( gait, balance, coordination);
• audible tinnitus;
• visual impairment;
• syncope and other types of impaired consciousness;
• violation of speech function;
• violation of understanding of interlocutors;
• paresthesia in the extremities( shivers, chills, etc.);
• weakness in the muscles of the limbs, the inability to move them;
• asymmetric pulsation on the upper limbs;
• lack of pulse on the upper limbs.

Also, an important study of duplex scanning is presented to patients over the age of 40 years , with a history of acute cerebrovascular accident in the ONMC - and TIA - to transient ischemic attacks, with arterial hypertension, diabetes, elevated blood lipids, high body weight and the plannedoperation on the myocardium.

Contraindications

Currently limitations to the use of this modern technique there is no , and for any age group of patients. Only in some cases, calcified atherosclerotic plaques can interfere with the passing ultrasound beam.

And of course we should not forget that the high professionalism of the doctor and the good equipment of play a key role in deciphering the results of duplex scanning, so if the medical organization does not have professionals in this field or suitable devices, it is better to do other methods of diagnosing the pathology of brachiocephalicvessels.

How to prepare

In general, this non-invasive procedure does not require special preparation of against the background of the absence of serious contraindications to the conduct.

In addition, be sure to consult with a doctor, if you are taking medications that affect the functioning of the cardiovascular system. In the case when it is possible to cancel taking drugs during the study of the brachiocephalic pool, this should be done, and the doctor will help to assess the risk of the effect of these drugs on the results of the duplex.

Procedure of

When examining the neck, the patient assumes a supine position on the back, with either a roller or a rigid cushion placed under the patient's head. To perform the scan, must be stripped of the neck and removed from it with all ornaments.

The patient should turn his head in the opposite direction to the device, after which the specialist applies a special gel to the skin, which is a means for better conducting ultrasonic waves in the body tissues.

When driving a sensor, first examine the carotid arteries, beginning with their lower sections near the sternum and ending behind the angle of the lower jaw. Inspect the place of division of the carotid artery into the outer and inner trunk branches from both sides.

In detecting pathological changes, is carried out a more thorough examination of all vessels leaving these branches. It is also necessary to scan the vertebral arteries, which are clearly visible with respect to the vertebral bodies of the cervical spine from the side, and also pass between their transverse processes in the longitudinal direction.

Duplex scanning of cerebral vessels is carried out through the skull structures of the skull, which determines a somewhat different tactic of the researcher. Several sensors are applied to the patient: on the two sides of the whiskey, in the supraorbital areas, the point of connection of the vertebral column and occipital bone and to the occipital region itself. Before finally installing all the sensors, the same specialized transparent gel is applied.

All research can take as 20-25 minutes, and hour. Everything depends on the capabilities of the medical organization's equipment and the professionalism of the doctor's examining vessels.

The interpretation of the results is carried out in accordance with the following indicators:

• the thickness of the vessel wall;
• presence of irregularities on the outer and inner surfaces of the vessel;
• the value of the lumen of the vessel;
• blood flow characteristic of the vessel;
• blood flow rate;
• anatomical features of the vessels.

In the presence of unevenness, an expert may think of about an atherosclerotic or thrombotic lesion of the vessel. These conditions are extremely dangerous for the patient in terms of development of strokes. In case of a decrease in the lumen of the vessels, one speaks of its stenosis and assesses the degree of constriction and localizes this place.

Normal results

For different vessels of the brachiocephalic zone, there are individual individual standards based on the results of duplex scanning. For a common carotid artery, a diameter of 4-7 mm is considered normal, a systolic blood flow velocity of 50-105 cm / sec, a diastolic velocity of 9-36 cm / sec, and an index of vessel resistance of 0.6-0.9.

For the branches of the common carotid artery, the following values ​​are acceptable:

• inner branch diameter - 3-6.5 mm;outer branch - 3-6 mm;
• systolic blood flow velocity of the internal branch - 33-100 cm / s;outer branch - 35-105 cm / sec;
• diastolic blood flow velocity of internal branch - 9-35 cm / sec;outer branch - 6-25 cm / sec;
• the index of resistance of the inner and outer branches is 0.5-0.9.

Normal parameters of vertebral arteries:

• diameter - 2-4.5 mm;
• systolic blood flow velocity - 20-60 cm / sec;
• diastolic blood flow velocity - 5-25 cm / sec;
• resistance index is 0.5-0.8.

Deviations

As already mentioned above, a specialist can detect a non-homogeneous structure of the vessel wall, its thickening or diminishing, narrowing of the lumen diameter, acceleration or slowing of the blood flow, its turbulent flow, plaques of atherosclerotic origin or thrombi presenting a serious barrier to blood flow.

What diagnosis can I put:

• atherosclerosis of the vessels of the head;
• thrombosis of these vessels;
• trauma to the vascular wall;
• aneurysm;
• dyscirculatory encephalopathy;
• arterial anastomoses and shunts with veins.

Average cost of

This type of diagnostic techniques is quite modern and requires the use of specialized equipment and medical personnel. Therefore research prices do not differ in their liberal nature .

Duplex scanning of brachiocephalic vessels is certainly one of the most progressive methods for assessing the state of the cardiovascular system in patients with suspected thrombosis and atherosclerosis. For more information about the study, see the video:

The ease of use of ultrasonic sensors and the high informativeness of made this procedure popular in medical practice. However, reliable research requires high-quality equipment and trained doctors, which is not available at every hospital.