What is the name of the ultrasound of the veins on the legs. Ultrasound examination of the vessels of the lower extremities. Ultrasonic dopplerography of vessels

Ultrasound is a highly informative diagnostic method based on the reflection of waves. Penetration through tissues of different densities, ultrasound is beaten off with unequal strength. Special sensors capture these vibrations and transform them into a graphic image. This method of medical examination has no contraindications, it can be used to accurately determine the localization and degree of pathological processes in any organ.

Ultrasound of the veins of the legs is performed according to the appointment of a phlebologist during the diagnosis of thrombophlebitis, obliterating diseases, varicose veins, before surgery.

What is ultrasound and ultrasound of the vessels of the legs?

Two-dimensional Doppler ultrasound, or USDG of the arteries, is a non-invasive and absolutely painless study of the valvular apparatus, deep and superficial veins. This method is based on the Doppler effect - changes in the frequency of ultrasonic waves reflected from moving blood molecules.

The received signals are recorded by ultra-sensitive sensors and transmitted to the dopplerograph, which reproduces the picture in graphic or sound mode.

Method features and benefits

Ultrasound is used to diagnose early and latent stages of obliterating diseases of the lower extremities. The doctor receives information about the state of arteries, veins, detects pathological changes in the vascular walls, atherosclerotic processes, thrombotic masses, areas of compression, stenosis, aneurysms.

Ultrasound examination of the veins of the lower extremities accurately determines varicose veins, its degree, valvular insufficiency, retrograde reflux, and detects blood clots that disrupt the normal movement of the bloodstream.

Diagnostic examination helps to accurately visualize their location, diameter and structure.

Ultrasound Dopplerography of the veins of the lower extremities has its drawbacks. These include the fact that the doctor cannot check the volume and speed of blood flow, the diameter of the arteries, since there is no volumetric visualization of them. Research opportunities are limited when examining deep and perforating vessels.

Ultrasound and triplex diagnostics

Duplex scanning (DSS) is based on the Doppler signal and the energy mapping method. Allows you to show and evaluate the condition of deep and superficial veins, arteries, the degree of their patency, the solvency of valves, the strength of blood flow, to identify even very small atherosclerotic plaques, aneurysms, blood clots, inflammation, damage to the walls.

Based on the results obtained, the doctor accurately determines the areas of obliteration and the causes that caused the narrowing of the lumen of the arteries of the extremities, impaired blood flow.

Triplex ultrasound of the vessels of the legs is performed in the same way as ultrasound, but with the addition of color Doppler. The image is obtained in 3D format using 3 modes, hence the corresponding name. On the computer monitor, the doctor sees the bright outlines of the veins in blue and red against the background of a general black and white picture. A color, two- and three-dimensional image is obtained by encoding the speed graph.

Main indications

Ultrasound of the vessels of the lower extremities is used to diagnose many diseases. An examination is necessary for patients suffering from the following ailments:

• varicose disease;
• inflammation of the venous walls - thrombophlebitis;
• chronic atherosclerosis;
• diabetic angiopathy;
• deep vein thrombosis;
• post-thrombotic disease.

The indications for the study are swelling of the extremities, spider veins, pain after physical exertion, redness of the skin, the formation of non-healing ulcers, cramps in the calf muscles, deformation of the saphenous vein network, formation of nodes, heaviness in the legs in pregnant women.

It is necessary to examine patients with complaints of numbness, tingling of tissues, pallor or cyanosis of the dermis, chilliness in the feet, intermittent claudication.

Ultrasound is prescribed not only to identify the disease, but also before the operation, to assess the effectiveness of the treatment. Dynamic observation is carried out after thrombosis therapy, lumen occlusion, as a screening diagnosis.

How to prepare?

Special preparation before visiting the diagnostic room is not required, so the study is allowed at any time convenient for the patient. The phlebologist sends the patient for ultrasound examination of the arteries and veins; if desired, you can perform a scan of the limbs on your own without a doctor's referral.

Methodology

UZDG and UZDS are done in a horizontal position or standing.

The patient lies on a hard surface with the feet shoulder-width apart and the feet turned outward. When examining the popliteal and small saphenous vein, the patient turns over on his stomach. The study of the lower leg is carried out in the vertical position of the leg, for this the person stands up or bends the limb at the knee.

An acoustic gel is applied to the skin, providing contact and easy sliding of the sensor, which is applied to the control points in the projection of the vessels. The sonologist examines the graphic image on the monitor, hears the characteristic sound caused by the movement of blood.

During the examination, proximal compression, cough and Valsalva test are used. To exclude the presence of a thrombus, the sensor slightly squeezes the various segments. The patient is asked to hold his breath, cough and tighten the abdominal muscles. In a healthy person, when inhaling, the venous blood flow is weakened, and when exhaled, it is restored. With fibrosis of the valves, retrograde reflux of blood occurs.

The whole procedure lasts no more than 45–60 minutes, does not cause pain or discomfort, and can be repeated several times.

After performing the primary ultrasound of the veins, the doctor decides on the need to use a duplex, color mapping, the advisability of performing CT phlebography, fibrophleboscopy.

Deciphering the results

Only a phlebologist can correctly interpret the answers of an ultrasound examination of the vessels of the lower and upper extremities. The doctor carefully studies the comments, the protocol issued by the sonologist, and makes a conclusion about the condition of the veins, valves and blood circulation speed.

Decoding of ultrasound indicators of large veins and vessels of the lower extremities is normal:

• Natural, main type of blood flow in the large artery of the thigh.
• The speed of blood flow in the femoral artery is 1 m/s, in the leg area – 50 cm/s.
• The resistance index of the large vessels of the thigh must be at least 1 m/s.
• The Gosling index in the arteries of the limb is not lower than 1.7 m/s.
• ABI (ankle-brachial index) - not less than 0.9.

With an altered blood flow, narrowing of the lumen of the vessels is detected. Turbulent flow is diagnosed with stenosis, collateral flow may be a sign of a lack of blood supply in the veins below a certain area.

A decrease in the values ​​of the pulsation and resistance index indicates obliteration of the arteries. With a decrease in the ankle-brachial index, violations of the patency of large vessels are diagnosed.

During the examination of the superficial and deep veins of the lower extremities, the wall thickness is measured, the presence of blood clots, pathological refluxes, and the relationship between blood flow and respiration are detected.

The doctor determines the performance of the valves, the localization of the perforating veins. If thrombotic masses were detected during the ultrasound scan, their characteristics, consistency, degree of occlusion of the vessel lumen and response to squeezing by the sensor are evaluated.

Normally, the walls are anechoic, elastic, and collapse during compression tests. When examining veins in color mode, the monitor will show a uniformly colored cavity. In case of valvular insufficiency, retrograde reflux occurs after respiratory and cough tests.

Conducting ultrasound of the vessels of the legs at home

If it is difficult for the patient to move independently, a duplex examination of the veins and arteries of the lower extremities can be done at home.

To do this, you need to call a doctor, such services are provided by a large number of paid clinics in large cities. The cost of the procedure will be higher than in a medical institution.

The advantage of ultrasound examination of the vessels of the legs at home is the ability to carry it out in comfortable conditions for the patient, round-the-clock work of doctors, and obtaining the protocol of the study in hand. If the diagnosis of the veins of the extremities will be carried out according to emergency indications, then the doctor will respond to the call at any time of the day.

To establish a diagnosis, the sonologist interviews the patient, finds out complaints, and assesses his general condition. Additionally, you will need to visit a phlebologist or vascular surgeon, conduct other laboratory, instrumental studies.

Contraindications and disadvantages

Ultrasound diagnostics of the blood vessels of the lower extremities has a small number of contraindications. It is impossible to examine the patient if this can lead to a deterioration in the person's well-being.

It is forbidden to do ultrasound in the following cases:

• violation of the integrity of the skin in the study area;
• acute infectious diseases;
• disorders of the nervous system;
• allergic reaction to the composition of the acoustic gel;
• emergency conditions - stroke, myocardial infarction, heart failure.

Relative contraindications include intense swelling of the extremities as a result of lymphostasis, obesity, and a large amount of subcutaneous fat.

During an ultrasound scan, it is difficult for a doctor to examine small vessels. Areas of calcification that appear in atherosclerosis can interfere with the passage of ultrasonic waves. The information content of ultrasound diagnostics depends on the qualifications of the doctor. The procedure cannot replace angiography, computed tomography: usually, studies need to be carried out in a complex manner.

How much does a vascular scan cost?

The price for ultrasound, ultrasound of the arteries of the legs depends on which clinic the procedure will be done in. In private medical institutions, the cost of research is higher than in public ones. However, most modern diagnostic centers operate on the latest devices, which allows for the correct diagnosis and timely treatment.

In Moscow and other large cities, ultrasound of the veins of the lower and upper extremities will cost on average from 2 to 5 thousand rubles, in regional hospitals the prices are low, but the pricing policy depends on the level of accreditation of the laboratory. To find out how much the examination will cost, you need to call the clinic operator.

Ultrasound duplex scanning of the blood vessels of the lower extremities is a non-invasive, highly informative method for diagnosing obliterating diseases. According to its results, inflammatory, pathological processes in large arteries, expansion of superficial and deep veins, blood clots, lumen occlusions, and circulatory disorders are detected.

Content

Foot health is determined by the prevention of pathologies, competent care, timely diagnosis of diseases. To examine the vessels of the legs, ultrasound (ultrasound) is often used. It helps to identify violations, differentiate them from others, keep records of the effectiveness of the prescribed treatment.

Types of ultrasound examination of blood vessels

The procedure for ultrasound examination of the vessels of the lower extremities is a simple, common and safe examination technique that has no absolute contraindications. With the help of the procedure, accurate information about the condition of the arteries is obtained.

The essence of the study is the penetration of waves of different density through the boundaries of tissues. Ultrasound is reflected from tissues and recorded by equipment that visually displays information. As a result, the doctor receives a picture of the state of the vessels of the legs. All types of ultrasound are divided into dopplerography, scanning and triplex examination.

Evaluation of blood vessels and detection of pathologies of the lower and upper extremities is carried out by ultrasound.

The method helps to identify existing problems and prescribe competent treatment of identified venous abnormalities.

With the help of ultrasound, diseases can be diagnosed at an early stage.

A qualitative diagnostic assessment is possible by calculating the following parameters:

• lumen diameter;
• wall evaluation;
• blood flow analysis;
• features of blood flow using a special triplex 3 D-mode.

Ultrasonic dopplerography of vessels

Ultrasound scan easily detects blood flow disorders, but it is not always possible to establish the cause. This method does not visualize the walls of blood vessels and their pathological bends, but they affect the speed of blood flow and its quality. Doppler examination is prescribed for symptoms of obliterating diseases: endarteritis, Takayasu's disease, atherosclerosis of the vessels of the feet; varicose veins.

Duplex scanning of the veins of the lower extremities

When conducting ultrasound, a two-dimensional color image of the examined sector of the limb is transmitted to the monitor. The advantages of the technique are the objectivity of the results, the ability to obtain data on structural changes in the walls. In real time, background and induced blood flow parameters are recorded, and peripheral circulatory systems are checked. The technique finds out the causes of obstruction of the circulatory system, provides information about the valves of the veins.

Ultrasound of the vessels of the lower extremities of this type is the fastest in time, accurate, but the price for it is higher than for the rest. It expands the capabilities of duplex by adding color Doppler modes, i.e. a color image of the movement of blood in the vessels, which can more clearly judge the direction of blood flow and its speed, as well as allowing a more accurate assessment of vascular patency and the degree of stenosis. Three goals are achieved, which determined the name of the method - triplex:

• the anatomy of the vessels is studied;
• blood flow is assessed;
• an accurate assessment of the patency of the vessels in the color mode is made.

When is the diagnosis of the vessels of the legs needed?

Ultrasound of the vessels of the lower extremities and other subspecies of ultrasound have the following indications according to phlebologists:

• heaviness in the legs after prolonged standing work;
• convulsions;
• visible saphenous veins;
• pallor and darkening of the skin;
• aneurysms;
• weakness of the body for no reason, the inability to stand for a long time.

Detectable pathologies

Dopplerography of the vessels of the lower extremities and other types of diagnostics help to identify such pathologies:

• varicose veins;
• asymptomatic initial vascular lesions;
• the presence of segments of narrowing of the arteries (stenosis);
• disturbed blood flow;
• the presence of cholesterol plaques;
• a- and hypoplasia;
• thrombus in the vessels;
• aneurysms;
• thromboembolism;
• phlebothrombosis;
• Raynaud's syndrome;
• valvular disease;
• chronic vascular insufficiency;
• extravasal compression;
• trauma, arteritis; post-thrombophlebitic syndrome.

How to prepare for an ultrasound of the veins of the lower extremities

• it is advisable to give up smoking for a day;
• in the norm for 3 days - from alcohol and drugs that affect the state of blood flow;
• do not use strong tea, coffee and other artificial stimulants;
• it is important to remain calm before carrying out.

How is vascular ultrasound done?

The procedure for conducting an ultrasound examination is carried out in stages. Steps:

1. Undress to underwear.
2. Lying on the couch, spread your legs shoulder-width apart.
3. After the specialist will apply a gel to the surface of the skin, he will drive a sensor to read the state of the vessels. When diagnosing, you will need to get up at the request of the doctor.
4. An ultrasound of the arteries measures blood pressure. With ultrasound of deep veins, you additionally need to “strain” and not breathe for a while.

What does an ultrasound of the veins of the lower extremities show?

The study determines the location, evaluates the patency of the vessels. The doctor judges the functionality of the valves, anomalies that affect blood flow. Researched indicators:

1. ABI - ankle-brachial index. A value from 0.9 to 1.4, with an increase in pulsation, they indicate increased loads. At a low rate, patency is impaired.
2. The index of pressure between the shoulder and the finger - the limits are set at 0.8-0.9.
3. The blood flow velocity in the femoral artery is 100 cm per second, in the lower leg - 50 cm per second.
4. The resistance of the femoral artery is at least 1 m/s, with a deviation they speak of ischemia.
5. The pulsation index of the artery is above 1.8 m per second. At low rates, narrowing can be judged.
6. Main blood flow for large arteries. With deviations, there are narrowings. Turbulent flow indicates stenosis. The causes are thromboembolism, a tumor.

Ultrasound of the vessels of the upper and lower extremities is one of the most informative, safe, and fastest diagnostic methods that allow assessing the degree of vascular pathology and identifying it at the early stages of the disease. The initial method of examination is ultrasound of the vessels of the upper and lower extremities. Supported by duplex angioscanning (USDS), this technique has no analogues in terms of studying the pathology of the vessels of the upper and lower extremities.

Principles of vascular ultrasound

The ultrasound method is based on the ability of low ultra-frequency reflections from objects in motion. Analyzing the data obtained by means of ultrasound sensors, a specially compiled algorithm (computer program) builds a graphical representation of the features of blood flow and vascular structure. A number of devices allow you to see a color image of the recorded processes. The movement of blood and the pulsation of the veins and arteries of the upper and lower extremities can not only be seen, but also heard.

Indications for ultrasound examination of the lower extremities

Ultrasound of the vessels of the lower extremities is a safe and affordable research method. However, like any medical procedure, it should be used according to indications and under the supervision of a medical specialist. If you have any disturbing symptoms, you need to contact a phlebologist.

Indications for ultrasound of the arteries and veins can be:

• parasthesia (tingling, crawling, numbness);
• telangioctasia (spider veins), visible expansion of the venous walls;
• swelling in the legs, feet (with a predominance of unilateral);
• changes in the color of the skin of the legs (from brown to purple);
• long-term non-healing wounds/scratches, trophic ulcers;
• pain, heaviness and cramps of the calf muscles;
• pallor or cyanosis of the skin of the feet;
• skin itching in the leg area;
• night pains in the calf muscles;
• weakness in the legs, noticeable during exercise;
• intermittent (appearing and passing) lameness;
• cold extremities regardless of the ambient temperature;
• a decrease in the volume of the lower leg, a decrease in hair growth, etc.

Additional indications for an ultrasound examination of the vessels of the lower extremities are: hypertension, diabetes mellitus, obesity. As well as myocardial infarction and vascular surgery on the legs, an increase in the level of "bad" cholesterol in the blood.

Types of ultrasound diagnostics of blood vessels

There are a lot of questions about the terminology of ultrasound diagnostics. What is the correct name for this study? Any study using ultra-low frequencies is an ultrasound. There are several hardware methods for angiodiagnosis of arteries and veins, both of the upper and lower extremities:

• Ultrasound Doppler/Doppler- graphic registration of blood flow, with the determination of the quantitative and qualitative characteristics of its speed. It is used to detect diseases of the arteries and veins of the upper and lower extremities. The method is quite simple, takes a little time, there are portable devices that will allow examination of seriously ill patients.
• Duplex angioscanning (USDS or USAS). This is a combination of spectral Doppler study and color mapping. Areas with different blood flow speeds are colored in different shades, opposite colors are colored in different directions of blood flows (from the sensor and to the sensor). Allows you to determine the state of the vessel, its anatomical features and defects, evaluate the blood flow, its qualitative and quantitative characteristics.
• Triplex angiscanning of blood vessels- Volumetric color study of the vascular system. It is of the greatest value in preoperative examinations. Suitable for those patients who have a serious pathology of the arteries and veins of the lower and upper extremities.

Where can I do an ultrasound of the vessels of the lower extremities? The studies described above are available at any phlebology center or medical institutions that include the Department of Vascular Surgery.

Preparation for ultrasound diagnostics of the lower extremities

This procedure does not require special preparation, diet, withdrawal of venotonics or other drugs that you take on an ongoing basis, etc. The usual hygienic procedures of the body and feet are welcome as preparation. The main preparation is to take a diaper (lay the couch) with you and remove the compression garment (if you wear one) before the examination.

Ultrasound diagnostics of pathological processes in the veins and arteries of the legs

Diseases of the venous system of the lower extremities require constant monitoring in order to timely determine the need for surgery or track the effectiveness of treatment.

There are no analogues in terms of safety, informativeness, harmlessness and accessibility to this method. Ultrasound of the vessels of the legs allows diagnosing the following pathologies with a high degree of certainty:

• CVI - chronic venous insufficiency;
• phlebothrombosis - blockage of a vein by a thrombus without inflammation of the vascular wall;
• thrombophlebitis - blockage of a vein by a thrombus with inflammation of the vascular wall;
• varicose veins;
• acquired valvular insufficiency of the venous system of the lower extremities.

Only with the help of ultrasound it is possible to mark the veins before surgery. Any violations of arterial blood supply require diagnostic procedures, primarily ultrasound. The main ones are:

• aortic pathologies;
• thrombosis and embolism of arteries;
• obliterating diseases (endarteritis and atherosclerosis) of the arteries;
• Raynaud's syndrome;
• HAN - chronic arterial insufficiency;
• aneurysms of peripheral arteries, etc.

Transcription of ultrasound readings

In medicine, certain standardized methods have been adopted for recording the results of an ultrasound study of the vessels of the upper and lower extremities. A correct understanding of the record allows you to assess the degree of development of the disease, and the doctor to prescribe or correct the course of treatment.

The main indicators are as follows:

• blood flow velocity recorded during contraction and relaxation: maximum (Vmax) and minimum (Vmin);
• index of peripheral resistance (resistivity, RI);
• pulsation index - an indicator that characterizes the lumen of the vessel (PI);
• thickness of the intima-media layer (intima and middle shell, TIM).

Ultrasound of the vessels of the legs allows you to identify pathology at the very beginning of its development. In some cases, if you change your lifestyle (adjust nutrition, add physical activity for people suffering from physical inactivity, get rid of bad habits), you can reverse or at least significantly slow down pathological vascular processes. The only competitor in the field of angiodiagnosis for ultrasound is angiography, but due to its trauma, invasiveness and complexity of execution, ultrasound scanning remains the preferred method of examination in most cases.

Ultrasound of the veins of the lower extremities- a modern and non-invasive way to diagnose the state of the vascular system of the legs. A phlebologist recommends an ultrasound of the veins in the legs with complaints of a violation of sensitivity, burning sensations, fatigue, chills, leg fatigue, muscle spasms, as well as in the presence of dilated veins and vascular "asterisks". An examination of the veins is also necessary for venous insufficiency, thrombophlebitis, phlebitis, lameness of unknown origin. Highly recommended for diabetes. Ultrasound of the veins of the legs can be prescribed based on the results of coronary angiography, ultrasound and x-ray of the heart, tests for venous insufficiency, x-rays of the lungs.

This examination is carried out without prior preparation, there are no restrictions on the diet. Ultrasound of the legs of a child is carried out without age restrictions. The patient is examined, then the veins are examined in the supine position on the couch. After that, they are asked to stand up to assess the condition of the vessels of the veins on the legs in an upright position. The duration of the session is 40-50 minutes.

The ultrasound procedure itself has no contraindications, it is painless and absolutely safe for the patient, it can be performed repeatedly to track the dynamics of treatment. It is not carried out only in case of damage to the skin, ulcers, burns, dermatological diseases.

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Price

The cost of ultrasound of the veins of the lower extremities in Moscow ranges from 1000 to 8500 rubles. The average price is 2580 rubles.

Where to do an ultrasound of the veins of the lower extremities?

Our portal contains all the clinics where you can do ultrasound of the veins of the lower extremities in Moscow. Choose a clinic that suits your price and location and make an appointment on our website or by phone.