IN human body blood constantly circulates. She gets to every cell, supplies nutrients and oxygen. Sometimes the blood slows down when it encounters small obstacles.
When transporting blood, the hard work is done by the heart and blood vessels, which, like a network of roads and highways, envelop the body. Arteries drain and veins carry blood to the heart. A network of small capillaries carries fluid throughout the tissues.
In the human body, the circulatory system must work flawlessly. Difficulties begin when obstacles arise in the veins and arteries - plaques or blood clots, which at any moment can break away from the vessel wall and block the path of blood flow. This can lead to stroke, heart attack, embolism pulmonary artery. To avoid such tragedies, it is important to detect even minor changes in the condition of the veins in time.
Which organs can be examined with ultrasound?
Ultrasound is used to diagnose:
What does ultrasound show?
The doctor who performs the ultrasound sees where the flow speed and direction of blood slows down and speeds up, where the venous valves do not close. Additional equipment makes it possible to measure blood flow speed, giving an idea of the condition of the vessel walls and the length of the veins. It is possible to detect narrowing of the arteries caused by atherosclerosis, thrombosis and other blood vessel diseases in abdominal cavity, neck, arms and legs areas.
Ultrasound examination methods:
Common disorders of the circulatory system of the lower extremities
The most common diseases of the veins in the legs are varicose veins and thrombosis. The impact of various external and internal factors: heredity, uncomfortable clothes and shoes, pregnancy, excessive physical activity, uncomfortable working conditions and bad habits - contribute to the development of diseases.
When varicose veins occur, bluish veins and red networks of blood vessels first appear on the legs, then, if you ignore the first sign of the disease, whole clusters of ugly swollen veins appear on the surface.
Due to the influence of the described negative factors veins begin to lose elasticity and become deformed. The walls become thinner and weaker, leading to stagnation of blood in the vessels. Rapid fatigue in the legs, aching pain, and a feeling of heaviness appear. If the disease is not diagnosed in time, a serious complication can develop - thrombosis.
Thrombosis, or venous thromboembolism (deep vein thrombosis), develops not only due to untreated varicose veins. The causes are hormonal changes, the consequences of surgery, changes in the walls of blood vessels due to a previous heart attack or stroke, changes in hormonal levels, asthma, chronic leukemia.
Stagnation of blood forms a blood clot on the walls, interfering with the free flow of blood, slowing down the speed. Blood begins to stagnate in the problem area. The formation of a blood clot does not threaten a person’s life, but its detachment from the walls of the veins can lead to pulmonary embolism and death in a matter of seconds.
Sometimes the blood clot breaks down on its own, but often, if the blood flow is improper, the formation of new blood clots becomes a matter of time. When the body does not destroy the clot, the formation grows, closing the veins like a plug.
Symptoms of blood clot formation include: sharp pain, unable to stand or walk. The pain is accompanied by swelling. Thrombosis forms in certain areas of the legs: the ankle, around the lower leg or thigh. The process is often accompanied by fever and tachycardia. Removing thrombosis requires serious treatment and surgery. Such leg diseases can be asymptomatic.
Primary symptoms should not be underestimated. People think they shouldn’t run to the doctor because of swelling or discomfort in their legs. A person ignores even persistently aching pain. Patients with a progressive disease who have noticed unusual symptoms by accident or as a result of complications come to the doctor for an appointment.
Similar leg diseases develop in adults, regardless of age. With the aging of the body, the risk increases many times over, the walls of the veins lose flexibility, the blood becomes thick, leading to valve damage and stagnation.
- sharp, stabbing pains;
- numbness, paresthesia (sensitivity disorders, tingling), symptom of “heavy legs”;
- cramps or swelling;
- slow-healing leg ulcers;
- change in skin thickness from brown to pinkish-purple on the lower legs;
- phlebeurysm;
- itching not related to another disease;
- thrombosis.
At the first symptoms, ultrasound of the veins in the legs is performed by people suffering diabetes mellitus, smokers, with elevated level cholesterol.
Ultrasound examination process
No ultrasound required special training. When examining the blood vessels of the liver and renal arteries the patient comes on an empty stomach.
There are no age restrictions - diagnostics can be performed on young children. It is allowed to repeat the required number of times. The method does not assume surgical intervention, painless, does not require anesthesia. A person experiences mild discomfort only when applying cold gel to the skin.
The patient removes clothing and jewelry from the legs that could interfere with an accurate diagnosis. Before performing the procedure, the ultrasound specialist examines the patient’s medical history and complaints. Apply to the test site special gel, which improves the conductivity of the ultrasonic wave and the movement of the device’s sensor.
Ultrasound diagnostics of veins is carried out first in a lying position, then in a standing position, the doctor asks the patient to inhale and hold his breath for a short time. This is required to check the movement of blood from superficial vessels to deep ones. In selected cases, the doctor recommends that the patient lie on his stomach for a segmental examination of the veins.
After the diagnosis, the doctor describes each vein, its condition, the presence of wall thickening, the presence of blood clots, and the functioning of the valves. Vascular ultrasound lower limbs performed in a lying position on the stomach, in the area from the groin to the ankle.
During an ultrasound, the doctor changes the frequency of the emitted ultrasound. The result is visible immediately. The doctor first describes the visual conditions of the vessels and their location, the presence of plaques, their concentration and location. Next come special indicators: type of blood flow, flow rate, value blood pressure, LID index, pulsation index, resistive index, percentage of stenosis. Depending on the type of examination, a map or color drawing is attached to the ultrasound description.
The duration of an ultrasound examination of the legs is 10-25 minutes, depending on the anatomical characteristics of the patient. The price depends on the type and complexity of scanning.
Ultrasound of the veins and vessels of the lower extremities is a modern, highly informative method for studying blood supply, which allows you to track the most minor deviations from the norm in the condition of the arteries, peripheral capillaries, and veins in the legs. Diagnosis is carried out in clinics, diagnostic centers or in a hospital setting. The equipment is available in almost any medical institution where ultrasound examinations are performed. Doppler angiography and duplex scanning clarify the diagnosis and allow the specialist to see the full clinical picture pathology.
Types of research
Ultrasound of the veins of the lower extremities displays reliable information about the condition of the blood lines - the lumen of blood vessels, thinning or weakening of the venous walls, varicose veins, and allows you to assess blood flow. A specialist, based on the study, assesses the degree of damage circulatory system, stage of the disease, location of its placement. Also, guided by the conclusion received, the doctor draws conclusions about the functioning of the entire cardiovascular system.
To collect complete information The modern diagnostic base uses several analysis methods:
- Angiography is a type of ultrasound of the veins and vessels of the lower extremities, designed to check the condition of the main lines (valve functionality, defects and lesions of the walls, the presence of blood clots and atherosclerotic plaques, wall thickness, physiological location of blood vessels, etc.).
- Doppler mapping - allows you to track the speed of blood flow, the patency of veins and arteries, assess the functioning of the valves and the tone of the walls of blood vessels. Demonstrates the presence of blood clots, aneurysms, varicose veins, and disturbances in the movement of blood flow.
- Ultrasound method - duplex scanning of veins Today it is considered the best method research that gives the most accurate idea of the state of the circulatory system. Allows you to qualitatively and quantitatively assess blood flow, the condition of the walls, any types of blockages, detects functional and organic pathologies of arteries and veins.
- Triplex scanning is a type of duplex study that allows you to view veins, arteries and their location in the form of a three-dimensional diagram. The method is relevant when preparing for surgical interventions, so that the surgeon can navigate the surgical field.
In some cases, the doctor may prescribe a full range of ultrasound examinations in order to thoroughly analyze the condition of the external and deep veins, arteries and capillaries. This amount of effort is most often spent on patients who first consulted a doctor about leg pain and who have been diagnosed with chronic diseases.
Indications for the study
The appointment for the study is given by a phlebologist. Ultrasound of the veins of the lower extremities should be performed for the following complaints and signs:
- A constant feeling of tiredness in the legs that does not go away after a night's sleep and is not associated with additional physical activity.
- Pain and heaviness in the legs worsen in the afternoon.
- Swelling, discoloration of the extremities (permanent or periodic).
- Feeling of numbness, tingling.
- Inappropriate reaction to cold (itching, redness, “cyanosis”).
- Spider veins.
- Inadequate pigmentation in purple, bluish shades.
- Cramps in calves and feet.
- Reduced foot temperature at any time of the year.
If at least one of these signs appears, it is necessary to undergo diagnostics and establish the cause of the illness and the degree of threat. If you contact a specialist in a timely manner, it becomes possible to get rid of the disease early stages or stabilize the condition conservative methods therapy.
Chronic Disease Monitoring
Ultrasound of the veins of the lower extremities should be performed regularly for patients with chronic course venous and arterial pathologies of the circulatory system in the legs.
The following diseases require observation:
- Thrombophlebitis, atherosclerosis.
- Varicose veins, diabetes mellitus, lymphostasis.
- Endarteritis, venous insufficiency.
- Postthrombotic syndrome.
- Postoperative period, etc.
Availability and simplicity make it possible to conduct ultrasound of the veins of the lower extremities in a clinic, hospital, diagnostic center. A routine examination, as part of monitoring the course of a chronic disease, helps the patient and the doctor understand how well the patient is progressing. conservative treatment, what additional measures can be taken, and perhaps a verdict on the need for surgery.
Why research is important
The single circulatory system of the legs consists of three venous parts; some lines cannot be seen or felt. Therefore, it is so important to do ultrasound of the deep veins of the lower extremities, superficial and peripheral systems. Modern ultrasound diagnostic methods make it possible to examine in detail all three blood components, and, if necessary, do this in several projections.
The deep veins are most at risk; they are not visible to the naked eye, lack muscle fibers, but experience a powerful load - almost 90% of the blood runs through these highways. Ultrasound scanning and Doppler diagnostics allow a specialist to evaluate the work of veins invisible to the eye, and understand what the problem is, if any.
The doctor examines the following vessels:
- Saphenous veins(small, large).
- Inferior vena cava.
- Popliteal, iliac veins.
- Femoral and deep veins of the leg.
Each group of veins has its own normal values, any deviations from which are a sign of disease, even if there are no obvious external signs, discomfort or clinical manifestations defeats. Early diagnosis helps to avoid the development of the disease and take adequate measures for prevention possible pathologies.
How is the procedure performed?
There is hardly a person who does not know what it is ultrasonography and has not undergone this procedure at least once in his life. Approximately all patients understand how ultrasound of the veins of the lower extremities is performed. The entire session takes no more than 60 minutes.
To access the vessels being examined, it is necessary to remove clothing covering the legs; there is no need to remove underwear. Skin areas are treated with contact gel. During the examination, the patient assumes the body position that is necessary for a thorough diagnosis. Often it is necessary to change three positions - lying on your back, lying on your stomach and standing to identify vascular pathologies during exercise.
During the scanning period, the doctor moves the sensor along the skin area, at this moment an image of the vessels appears on the monitor in current time mode, changes are detected, and blood flow is assessed. At the same time, many devices make it possible to hear the characteristic noises produced by the flow of blood in the vessels. The examination is carried out by a phlebologist or a certified ultrasound diagnostic specialist.
Research objectives:
- Monitor the condition of tissues and blood veins.
- Assess the functionality of the venous system, valves, and each of its parts separately.
- Confirm or refute the development of thrombophlebitis, changes in the walls of blood vessels.
- Track anatomical features path of vessels, veins, arteries, capillary system.
The operator who carried out the diagnostics can give some comments on the results, but full transcript provided by the doctor. Ultrasound of the veins of the lower extremities - non-invasive, safe and exact method research.
Additional features
During the procedure, the patient may be asked to carry out a series of certain actions, which is necessary to clarify the presence or absence of certain vascular lesions. The most informative and frequently used tests are the cough test and the Valsalva test. These procedures help the specialist rule out or confirm the presence of a blood clot.
The patient holds his breath, coughs, and strains his abdominal muscles. With such actions, in a relatively healthy person, the venous flow weakens during inhalation, and stabilizes during exhalation. If the work is disrupted (fibrosis), then a reverse flow of blood occurs.
To obtain additional data, a coloring, microbubble gas is sometimes used and is administered to the patient intravenously. The drug does not harm health and is eliminated from the body during breathing without a trace. Preparation for ultrasound of the veins of the lower extremities is not required; diagnosis is carried out at any time.
Contraindications
Ultrasound of the veins of the lower extremities is absolutely safe and can be performed even on infants and pregnant women, but there are a number of limitations associated with the observation method.
Diagnosis is not carried out for the following diseases and conditions:
- Open wounds on the legs, injuries or extensive burns.
- Infectious skin lesions in the acute phase.
- Myocardial infarction.
- Heart failure, disorders cerebral circulation V acute form.
- Asthma attacks, cardiac arrhythmia.
Restrictions are related to the patient's condition. Ultrasound diagnostics are carried out in a supine position, which in a patient with cardiovascular pathologies can cause a sudden attack of the disease or aggravate the course chronic form diseases.
Open wounds and burns are not treated due to the inability to apply contact gel and carry out any movement on the surface of the body. Specialists have difficulty diagnosing the condition of blood vessels, especially deep veins, in obese patients; visualization is distorted and often blurred.
What does ultrasound of the veins of the lower extremities show?
The task of complex ultrasound diagnostics includes analyzing the current functional state of the circulatory system of the lower extremities, identifying disturbances in its operation, and determining the localization of problems.
In conclusion, the specialist describes possible diseases And general indications:
- Varicose veins are a pathology of the walls of blood vessels, causing dysfunction of the venous valves and affecting the outflow of blood.
- Deep vein thrombosis is the formation of blood clots (thrombi) in the lumen of blood vessels and obstructing blood flow. Blood clots are life-threatening.
- Atherosclerosis is the development of cholesterol plaque in the form of plaques on the walls of blood vessels. The lack of adequate therapy provokes the development of thrombosis, weakening of the venous walls, narrowing of the diameter of blood vessels, and obstruction of blood flow.
- Endarteritis is a lesion, followed by inflammation, of arterial capillaries. The process can spread to large arteries.
- Phlebitis is inflammation of the walls of veins. Provokes thrombosis.
These diseases are the most common and are caused by bad habits, sedentary lifestyle, unbalanced diet, obesity, influence environment and many other factors.
The interpretation of ultrasound diagnostic results should be trusted an experienced doctor With high level qualifications, he will be able to determine what is not visible in the photographs. For example, with high calcification of small vessels, they will not be visible in visualization; a specialist with broad knowledge will note this in the verdict.
What is written in the conclusion
A qualified interpretation of the results of ultrasound examination of the veins of the lower extremities allows us to identify even the slightest deviations in the functioning of the circulatory system. The interpretation of the study can only be entrusted to an experienced doctor - phlebologist or vascular surgeon.
The specialist evaluates the following indicators:
- Vmax - maximum value of blood flow speed.
- Vmin is the minimum blood flow rate.
- RI is an indicator of vascular resistance.
- PI - pulsation index.
- IMT is the thickness of the membranes of blood vessels (inner and middle).
Each blood line has its own normal indicators, based on which the specialist determines the condition of the patient’s blood vessels. You won’t be able to do this yourself, relying on average data.
The ultrasound procedure is available to almost all citizens. For example, how much will it cost to do an ultrasound of the veins of the lower extremities in Moscow? The price of the procedure varies significantly depending on the complex of studies and the place where it is performed.
With a high degree of information content of this type of diagnosis, it is additional. Based on ultrasound, the doctor cannot make a final diagnosis. To clarify it, the patient needs a comprehensive study of many health indicators, including lab tests, a series of certain tests, MRI, etc.
Where to take the study
For help and diagnosis, patients turn to a phlebologist at a clinic or medical Center. After conducting a superficial examination, the specialist will definitely prescribe a study and tell you where to do an ultrasound of the veins of the lower extremities. The devices are available in any clinic, diagnostic, consultation center where equipment for ultrasound diagnostics is installed.
You can also seek help from large public hospitals that have a department vascular surgery, in this case it will be possible to undergo the study for free. Ultrasound of the veins of the lower extremities is performed at home if the patient cannot arrive at medical institution. To receive the service, a doctor is called from the clinic; the cost of diagnostics with an on-site doctor and equipment will be more expensive.
The price for ultrasound diagnostics of the lower extremities is determined depending on the amount of work and research that will have to be carried out, which vessels and veins will be covered in the diagnosis. The procedure for ultrasound examination of the veins of the lower extremities in Moscow (we indicate the average price) ranges from 2 to 2.5 thousand rubles.
Who's at risk
Venous diseases are provoked by acquired, congenital, age-related factors or environmental factors.
Congenital ones include:
- Heredity (family history, coagulation defects, etc.).
Purchased:
- Blood clotting disorders.
- Obesity, neoplasms.
- Chronic diseases.
- Varicose veins, infectious diseases.
- Nephrotic syndrome, plaster fixation.
- Injuries, surgical operations.
- Pregnancy, postpartum period.
- Negative effects of the environment.
- Myeloproliferative diseases.
- Central venous catheter.
- Long-term or permanent use medications.
- Long journeys in a sitting position.
Ultrasound examination is not final for forming a verdict about the disease. In conclusion, the specialist describes general state external and deep veins, arteries, finds the reasons for the deviation of blood flow from the norm or states the fact of weakening of the venous wall, demonstrates the presence of blood clots, atherosclerotic plaques. The diagnosis is established on the basis of a set of studies and tests, an obligatory part of which is ultrasound of the veins of the lower extremities.
Ultrasound of veins and vessels is an ultrasound method that is used to assess the condition of the valve apparatus and blood flow of the vessels of the lower and upper limbs. Ultrasound scanning of veins allows early diagnosis of varicose veins, vascular thrombosis, thrombophlebitis, phlebitis and other vascular pathologies.
The advantages of vascular ultrasound include:
- Painless and non-invasive procedure;
- Harmlessness and safety (can be prescribed to pregnant women, children and the elderly);
- Lack of preliminary preparation;
- Highly informative (unlike x-rays, it allows you to study the condition of soft tissues and identify the presence of blood clots);
- Minimal number of contraindications.
Indications and contraindications for ultrasound
Examination of the vessels of the upper extremities is prescribed in the following situations:
- Numbness of hands;
- Tortuosity of veins;
- Pain along the vessels;
- Muscle weakness;
- Swelling of the upper extremities;
- Change in skin color;
- Suspicions of thrombosis, phlebitis, thrombophlebitis;
- Hand injury with vascular injury;
- Transferred surgical interventions on the veins of the upper extremities.
Ultrasound of the vessels of the lower extremities is prescribed if there are the following indications:
- The appearance of protruding, pronounced veins under the skin;
- Swelling of the legs;
- Cramps in calves;
- Change in the shade of the skin (the skin becomes pink, pink-violet, brown);
- Itching of the skin in the absence of dermatological pathologies;
- Tingling, numbness of the lower extremities;
- The occurrence of trophic ulcers on the legs;
- Suspicions of the development of diabetes mellitus, thrombophlebitis, varicose veins, post-thrombophlebitis syndrome.
Ultrasound of the vessels of the extremities in the diagnosis of diseases allows one to assess the severity of the disease, the level of spread pathological process, decide on therapeutic tactics and the need for surgical intervention.
The procedure for ultrasound examination of veins has no absolute contraindications. There are a number of relative restrictions that are temporary:
- The course of infectious and non-infectious inflammatory processes in the body;
- Skin diseases on the arms and legs (ulcers, wounds);
- Acute conditions(asthma attacks, myocardial infarction, bleeding, epileptic seizures);
- Burns of extremities;
- Exacerbation of mental illness.
Specifics of vascular ultrasound
Ultrasound examination of the vessels of the extremities does not require special preparation. During an ultrasound of the hands, the patient removes clothing up to the waist and possible jewelry. Having applied a special gel to the area of study, the doctor places an ultrasound sensor on the arm in the projection of the vessels, with the help of which he studies the characteristics of blood flow and the condition of the venous walls. If necessary, the procedure is repeated on the second hand.
To undergo an ultrasound of the lower extremities, the patient needs to undress to his underwear below the waist and lie on the couch on his back. After visualizing the vessels from the front, the patient turns over on his stomach and the doctor examines the limbs from the back. In some situations, ultrasound of the blood vessels of the legs is performed in a standing position. The duration of the procedure varies from 40 minutes to an hour.
You can sign up for an ultrasound examination of blood vessels in Moscow on our website. Ultrasound of veins is performed 24 hours a day, 7 days a week - call the numbers provided at any convenient time.
Human upright posture, formed in the process of evolution, has brought not only numerous advantages, but also vascular diseases of the lower extremities. According to statistics, every fifth woman and every eighth man suffer from pathologies of both deep and superficial veins.
To determine the extent, characteristics and localization of affected areas, ultrasound of the veins of the lower extremities is used - a simple, non-invasive method that allows one to identify the presence of abnormalities in the blood flow and structure of blood vessels. The absolute harmlessness of the procedure makes it possible to carry out it as many times as necessary.
Features of ultrasound examination of the lower extremities
Ultrasound of the vessels of the lower extremities provides a detailed study of the anatomy of the blood vessels, the state of the valve apparatus, the characteristics of blood flow and the localization of its disorders. The Doppler effect, which is the basis of the procedure, allows us to identify not only abnormalities in blood circulation, but also blood clots and inflammatory processes formed as a result. Dopplerography is a technique that involves reflecting ultrasonic waves from red blood cells moving along the bloodstream.
When it is carried out, the doctor receives a complete picture of vascular formations, blood flow speed and other nuances necessary for studying the veins in the legs. The emergence of this method was the reason for the appearance of a second name for ultrasound of the vessels of the legs and other parts of the body - “Doppler”. There are currently three types of Doppler ultrasound.
Ultrasound Dopplerography (USDG)
This method is the most common two-dimensional ultrasound diagnosis of blood vessels. Ultrasound ultrasound is used:
- to assess the patency of deep and superficial veins;
- determining the functional state of venous valves;
- diagnostics of typically located valves of perforating veins.
Ultrasound of the veins of the lower extremities in this way is considered an outdated technique, but in terms of screening examination it is quite informative. When performing it, the doctor is able to recognize the first signs vascular disorders. Therefore, the method is used mainly for preventive medical examinations or when it is not possible to conduct a more informative ultrasound of the legs.
Duplex scanning (USDS)
The technique is the most widespread today due to its high accuracy and information content in diagnosing the condition of the venous system. The essence of the method is to combine ultrasound scanning with online scanning. Ultrasound of the veins of the lower extremities allows the doctor to determine:
- state vascular walls and valves;
- patency of superficial and deep veins;
- the condition of the perforating veins, regardless of their location;
- presence of blood clots - their location, size, mobility;
- the degree of damage to the vein section due to formed thrombosis.
Ultrasound scanning of the legs is a quick and informative procedure
Duplex scanning makes it possible to evaluate functional state not only the deep veins of the lower extremities, but also the arteries, which as a result shows a complete picture of the vascular network of the legs. This procedure is an integral part at all stages of vascular research, therapy with subsequent monitoring of dynamics, as well as for monitoring in postoperative period.
Ultrasonic scanning with color mapping (triplex scanning)
This ultrasound method of veins and arteries of the lower extremities is one of the latest developments in the world of diagnostics. Triplex scanning involves not only assessing the characteristics of blood circulation in vessels in real time, but also color differentiation characterizing the speed of blood movement. Shades of red show blood flow going towards the emitter, and the color palette of blue shows the opposite direction. The richer and more intense the color image transmitted to the monitor screen, the higher the speed of blood flow.
IN Lately This technique is being used more and more often, since only it is able to show the most complete picture of all existing vascular abnormalities.
When is an examination necessary?
An ultrasound of the vessels of the lower extremities will be prescribed by a specialist if the following manifestations are present during examination and consultation:
- swelling of the legs of varying severity;
- dilation of veins, noticeable to the eyes;
- pain when walking and standing for long periods of time;
- frequent troubling cramps calf muscles;
- tingling or numbness of the lower extremities;
- presence of itching in the legs not associated with skin diseases;
- the presence of trophic ulcers;
- change in the color of the skin of one or both legs.
If the blood circulation in the leg veins is impaired, the skin can acquire multiple shades. This will be related to the degree of damage to the site and predicting the reversibility of the process. Thus, a pink or bluish faint tint indicates a minor degree and a favorable prognosis with proper therapy.
While large areas of dark purple or brown indicate dangerous violation with a high probability of developing tissue necrosis, which requires urgent medical intervention, perhaps even surgical. Modern devices make it possible to save many patients from the development of such complications, because ultrasound of the lower extremities shows almost all vascular abnormalities in the initial stages their occurrence.
Change in the color of the limbs due to the progression of varicose veins
In some patients, blood circulation is impaired not only in the legs, but also in the arms. Patients with diabetes mellitus often encounter such pathologies, which forces them to undergo an examination of the upper extremities. Diagnostic measures to study blood flow in the hands are recommended if you have:
- numbness and weakness;
- cold palms;
- for a long time non-healing wounds;
- difference in blood pressure different hands more than 20 mm Hg.
Heavy smokers, people suffering from diabetes and hypertension, as a rule, are at risk of developing vascular diseases of the extremities. This list also includes women who are in the 2nd–3rd trimester of pregnancy, which is associated with an increased load on the entire body, including the legs and the vessels that feed them. Compression of the pelvic organs during fetal growth often causes thrombosis of deep veins and even arteries.
What diseases require regular ultrasound diagnostics of the feet?
Indications for regular examination using ultrasound are based on a history of:
- varicose veins - enlarged veins;
- thrombosis – blockage of a vessel with blood clots;
- thrombophlebitis – inflammation of a vein due to blockage by a blood clot;
- postthrombophlebic syndrome to control the condition.
During the examination, the following are diagnosed:
- blood clots, atherosclerotic plaques– their size, structure and precise localization;
- quantitative and qualitative characteristics of blood flow;
- the presence of stenosis (narrowing) of blood vessels, and their degree of danger for the patient.
The high accuracy of the method and the possibility of performing real-time ultrasound of the arteries of the lower extremities makes it possible to perform complex operations, minimizing risks for the patient.
Preparatory process and procedure
No preparation is required for an ultrasound, except for routine ones. hygiene procedures. Therefore, diagnosis can be done at any time convenient for the patient. If an examination is planned in state hospital, then you should take a towel or diaper with you. Because ultrasound of leg veins is performed mainly in a lying position, and it will be more comfortable to spread something on the couch. To undergo diagnostics, the patient is invited into the office and given about two minutes to prepare - remove clothes from the lower part of the body and sit comfortably on the couch.
There is no need to remove your underwear - the procedure does not apply to the small pelvis. The legs are examined one by one - first, gel is applied to one and all projections of the vessels are carefully examined, then to the second. During the procedure, the patient does not feel anything - no pain or temperature. If present inflammatory process, for example, with thrombophlebitis, then when touching the emitter there may be slight discomfort.
Depending on the depth required for the study, the uzist will change the frequency settings of the emitted wave oscillations, but this will also be completely invisible to the examinee. When examining the arteries of the legs or arms, the doctor will apply cuffs to different parts of the limbs and measure blood pressure during the diagnosis. The examination is carried out in a standing and lying position. When examining the veins of the legs, the limbs are first examined with the patient lying down, and then he is asked to stand, and then the diagnosis is performed while standing.
Ultrasound diagnostics venous vessels of the lower extremities is also first performed lying down and then standing. In addition, there are functional tests allowing to assess blood flow from superficial to deep veins. To do this, the patient will need to take a deep breath, and then, without exhaling, strain. Such diagnostics can be performed in normal and color mode.
The procedure can be performed in the following positions: lying on your back, on your stomach and standing
Sometimes, to improve the quality of visualization of deep large veins, not only functional tests are performed with straining, but also with pressure on the area of the veins with different intensities. In some cases, poor circulation of some veins in the legs may be associated with damage to one or another joint, then in parallel, an ultrasound scan of the joints of the lower extremities is prescribed, which allows one to obtain a complete picture of the area being examined.
Interpretation of results
After the procedure, the received data is decrypted. This is done by an ultrasound doctor specializing in vascular diseases, phlebologist or vascular surgeon. Thus, when interpreting the results of examination of the arteries of the lower extremities, their anatomical characteristics are assessed: the thickness of the wall of the blood vessels, resistance indicators indicating the degree of patency and the presence of arterial stenosis, features of blood flow correlating with systole and diastole (phases of the heart muscle), blood flow velocity, its dynamic changes taking into account the characteristics of arterial vessels.
When describing venous vessels, a specific research protocol is used, in which each vein is assessed on the right and left sides. In this case it is indicated:
- is venous circulation in the extremities related to breathing;
- quality of compression of vein collectors;
- the presence or absence of thickening of the vascular walls;
- the presence of blood clots – thrombi – in the lumen of the vessel;
- consistency in the functioning of venous valves;
- the presence of pathological refluxes;
- localization of incompetent perforating veins more than 3 mm in diameter.
A thrombus formed near the valve is dangerous due to the possibility of tearing off and blocking the vessel
If a blood clot is detected, thanks ultrasound diagnostics, its full description is made, indicating by what percentage the thrombotic masses block the lumen of the vessel (if there is an overlap). In the absence of the fact of overlap, the characteristics of the thrombus are indicated - floating (movable) or near-wall, and whether the clot is prone to movement when touched by the emitter. The density of the blood clot is also assessed - dense or soft.
Based on all these data, the vascular surgeon develops therapeutic tactics, most suitable for each specific case. At the same time, regular examinations and ultrasound examinations of the legs are prescribed to monitor the healing process and avoid complications of the disease. Compliance with all treatment and preventive recommendations for patients significantly increases the chance of a speedy recovery without subsequent relapses.
Ultrasound examination of the vascular system of the legs means a procedure for examining the anatomy of veins and arteries, assessing their functioning, the condition of the valves and the characteristics of blood flow. The technique makes it possible not only to find out why blood circulation is affected in a particular area of the vessel, but also to identify inflammation or blood clots. Ultrasound of the vessels of the lower extremities is an important procedure for diagnosing existing problems and helps in planning the correct treatment.
To study the vessels of the lower extremities, a procedure based on the Doppler effect is used. In medicine, it means the reflection of ultrasound radiation from red blood cells flowing through the vessels.
As a result of a Doppler examination, the doctor gets an idea of the characteristics of the passage of the vascular cord, the speed of blood flow and other nuances of the functioning of the veins and arteries of the legs.
So what types of research are there, and what do they show?
USDG
The term “UZDG” means “ Doppler ultrasound" This is a technique commonly used for:
- establishing the patency of deep vascular collectors;
- assessing the condition of superficial veins;
- diagnostics of the condition of valves, including valves of typical main components of the venous system, that is, perforating veins.
UZDS
Duplex scanning combines the principles of Doppler and traditional methods examinations and performs the following functions:
- studies the operation of vein valves in real time;
- makes it possible to assess the condition of the vascular walls;
- allows you to analyze the patency of deep and superficial veins;
- calculates the presence and location of blood clots.
Technologically, the method remains the most popular and in an exact way evaluate the functioning of the venous system in all respects.
Online scanning
Online scanning is a complex that combines ultrasound and ultrasound scanning. It is intended to determine:
- condition of the walls of arteries and veins;
- valve health assessments;
- patency of vascular collectors;
- condition of the veins connecting superficial vessels with deep;
- the presence of blood clots and their characteristics, including size and location;
- degree of blockage of the vessel.
Ultrasound with color mapping
Most modern method studying the veins and arteries of the legs, it is distinguished by color identification of the speed of blood flow in different areas. For example, shades of red characterize the flow of blood to the sensor, and blue tones characterize the flow of blood directed away from the sensor.
Important! The brighter the color, the higher the speed of blood movement.
In modern diagnostics of arterial-venous pathologies, the popularity of this method is growing due to its high information content and simplicity.
Preparation
When referring veins and arteries of the legs for ultrasound (as well as others, as a rule), there is no need to carry out preliminary preparation for the procedure - it is not required.
How do they do it?
How is the deep veins and arteries of the legs diagnosed?
Video 1. The procedure for ultrasound diagnostics of deep vein thrombosis of the lower extremities.
Ultrasound examination of blood vessels looks like this:
- The patient enters the ultrasound diagnostic room, provides the doctor with a referral and frees the veins of the lower extremities. That is, he takes off tights or trousers, remaining in his underwear. The diagnostician applies a little conductive gel to the legs one by one, which will ensure better adhesion of the sensor to the surface of the skin.
- During the manipulation, the doctor can change the frequency of the sensor for better visualization of deep vessels, but the patient will not feel this in any way.
- The difference between ultrasound and ultrasound is that During the examination, the doctor will measure pressure in both the upper and lower extremities. During the procedure, the patient will change his position from sitting to lying and back.
- During the examination of the leg veins, they are first examined with the patient lying down, then he will be asked to stand up. In addition, as part of the survey special tests are carried out to determine blood flow between superficial and deep vessels. The test consists of taking a deep breath, without interrupting it, you need to make a strained effort.
- The deep veins of the legs are examined in traditional and color modes. For a better examination, the patient is asked not only to perform stress tests, but also the areas where the veins are located are palpated with different intensities. Such tests (like ultrasound itself) are performed in different positions: lying on your back or stomach, as well as standing.
Contraindications
In addition to the indications for ultrasound of the blood vessels of the legs, there are also contraindications.
Contraindications to duplex vascular examination are associated with the relatively long duration of the procedure - it takes about 40 minutes.
Photo 1. Thrombus on ultrasound of the veins of the lower extremities.
It may turn out that this examination turns out to be secondary and the study of adjacent tissues or internal organs comes to the fore.
Important! You should not perform an ultrasound in the area of the veins of the lower extremities if skin damaged or damaged.
The main contraindications to studying vessels using the duplex method are:
- acute infectious processes;
- any illness accompanied open wounds on the skin at the location of the sensor;
- burns;
- emergency conditions;
- mental illnesses that make it impossible to carry out the procedure.
- excessive fullness;
- bloating;
- cystitis and some diseases of the genitourinary system;
- lymphostasis, causing severe swelling of the limbs.
Advantages and disadvantages
The advantages of the ultrasound method of studying limbs are:
- no pain;
- non-invasiveness, that is, the absence of punctures and other damage to the skin;
- economic accessibility of the procedure;
- ease of implementation;
- absence of radiation or ionizing load;
- linking the research picture to real time;
- the ability to perform a biopsy under ultrasound guidance;
- good visibility of all soft tissue features;
- the possibility of repeated repetition (for example, during treatment therapy to monitor its effectiveness).
However, this innovative procedure also has negative aspects:
- there may be insufficient data for a complete diagnosis;
- Adequate assessment of small vascular formations is not always possible;
- with atherosclerotic changes, the patency of the ultrasound wave may be impaired;
- is not a replacement for angiography;
- If carried out on old equipment or with insufficient qualifications of the doctor, the procedure may have low diagnostic value.
It is important to note that sonologists strongly recommend periodically examining blood vessels, especially for patients who, due to their profession, spend a lot of time on their feet .
Arteries and veins also require increased attention in patients with excess body weight and cigarette addiction. Timely prevention will help reduce the likelihood of developing vein diseases.
How much does it cost where is the best place to do it?
It is best to contact your attending vascular surgeon, who will recommend a good specialist or tell you where and at what time he himself conducts ultrasound examinations.
In the Department of Vascular Pathologies, ultrasound can be performed free of charge, as prescribed by the surgeon. For a fee, in the absence of a referral, ultrasound examination of the extremities is carried out in phlebological clinics or multidisciplinary medical centers. You can find out the cost of the examination from the administrator by phone or by making a personal appointment. But it is better to refuse to perform vascular ultrasound in the offices of small diagnostic centers where any organs are examined.
Reference! The price of an ultrasound scan will depend on the specifics of the procedure and which vessels the patient needs to examine.
For example, for an ultrasound scan of the legs, the price will be from 1300 to 3500 rubles, and duplex angioscanning will cost 800–5000 rubles, color scanning using the duplex method will cost from 900 to 6500 rubles. On average, the cost of examining the vascular sections of the legs using ultrasound will cost about 2 thousand rubles.
There are also portable ultrasound machines, so ultrasound can be performed at home: this route naturally requires specific knowledge. But still It’s better to entrust this matter to a specialist.
Conclusion
Any patient, if indicated, can safely undergo angioscanning of blood vessels, because this manipulation is safe and painless. It does not require preparation and allows you to know exactly how healthy the vessels are an hour after the start of the examination.
