UDCG of the vessels of the brain( ultrasound doppler)
- 16 Aug 01:45
In this article, we will tell you about another type of diagnosis of the head, and, in particular, the vessels of the brain, ultrasound doppler( ultrasound doppler).You will also learn on the basis of which data is decoding the diagnosis and treatment process using this technology.
UZDG of brain vessels is used in cases where there are some clinical symptoms;Circulatory disturbance after a patient has suffered a stroke after severe head and neck surgery.
- General Information
- Features of the application
- What can be learned in the study of UDD and when it is used?
- According to the findings of the data?
- Decoding the results of neurosonography
- Restrictions that exist when performing ultrasound examination
- How is the treatment process?
As a rule, as evidence for this study, the same symptoms as headache attacks, arrhythmia disorder, nausea, vomiting, dizziness, visual impairment are the same. It is best to undergo this procedure only after the neck ultrasounds have been performed, namely those vessels that transport the necessary amount of blood to the brain.
During the ultrasound examination of the neck, vessels that feed both halves of the brain are studied, and then start with the same vessels that are already departing from the brain and moving further on the human body. Therefore, we can conclude that it is necessary to resort to such a procedure only after the specialists have been investigated absolutely all possible violations at a level quite remote from the brain.
All vessels of the brain begin with four so-called major arteries, namely, the left and right spine, and the right and left carotid arteries. The artery, as well as the anterior and middle cerebral arteries, gives rise to a carotid artery located in the inner part of the brain.
As far as the vertebral artery is concerned, it is connected on both sides to the main artery, which is then divided into two cerebral arteries, the right and the left back.
It should be noted that all arteries without exception are related to each other, and thus they form a peculiar ring, which, if necessary, redistributes blood circulation to the patient's body.
As a rule, the procedure is conducted through 3 types of access - the area of the nape, the eye and transtemporal access option, that is, through the thin part of the bone of the temple. With the help of infraorbital access, it is possible to evaluate the blood flow in both the supraclavicular and intraocular arteries.
Also, such an ultrasound detects blood supply to the brain that is abnormal, that is, completely unusual, if there is a blockage of a certain number of arteries inside the brain. Through the temporal region, ultrasound vessels of the base of the brain, namely, its anterior, middle and posterior arteries of the brain, Rosenthal veins, Galena veins, and also the so-called direct sinus, are performed.
The ultrasound of the vessels of the brain is used through a relatively huge hole in the area of the nape to explore all the departments that are inside the cranium, in particular, the main and vertebral arteries. In addition, carefully examined Galena veins with direct sinus.
When ultrasound of the vessels of the brain is performed, special compression tests are used to evaluate the capacity of the so-called Willisieva circle. If we talk about this Welsh circle, then this is a peculiar set of vessels that are at the base of the brain, which are interconnected in almost one whole design with the help of communicative arteries.
In the brain, the whole process of blood supply occurs in four arteries - sleepy: both left and right, as well as the left and right vertebral arteries. The posterior cerebral arteries begin from vertebrates, but sleepy, in turn, from the middle and anterior cerebral arteries.
In case of disturbances of blood supply to one of the listed arteries, blood flows will be distributed in such a way that the lesion area in any variant will be fully equipped with all the necessary at the expense of other vessels.
Some patients have a circle that is not closed at Willisyev, and accordingly, the compensatory features of the brain, in general, and the vascular system, in particular, will be substantially limited. Doppler examination of the vessels of the brain is carried out in order to detect aneurysms, as well as other abnormal vascular behaviors, as they should be in the same place on a permanent basis.
Considering the characteristics and rate of vascular velocity of the brain along with the trunk arteries, one can conclude that the general nature of the violation of blood clotting in the body, for example, a specialist will be able to determine hyperperfusion or spasm of the vessels. Similar conclusions are most often made if a person has received a serious craniocerebral injury, he has had a hemorrhage, both internal and external, some hormonal changes.
In addition, due to the ultrasound of the brain, it is possible to thoroughly examine all the characteristics of the ventricular outflow, which is carried out on the main veins within the cranial box, in particular, on the veins of Rosenthal and Galen. If there is an increased pressure, the blood flow rate in the above veins increases significantly.
Given all of the above, we can make a sure conclusion: thanks to the application of the procedure of ultrasound of the brain, namely the vessels that are located here, you can get a lot of valuable information. This diagnosis does not have any substitutes, if it is a question of what it is necessary to assess the disturbance of blood circulation in the brain.
Features of the application
The most commonly used for this type of study patients who experience severe headaches, and therefore people want to check their general condition and find out in what, in fact, the cause of such a disease.
When a person visits a specialist, he is confident that the causes will be fully disclosed, and the practitioner will almost immediately be able to answer the question of what to take and what course of treatment to go for in order to get rid of headaches.
Official statistics suggest that this diagnosis is effective only in about 10-15% of all cases of different modalities such as MRI( magnetic resonance imaging), PET( positron emission tomography), duplex scanning.
That is to say, in other words, about 10% of patients who have headaches suffer from the fact that this condition is caused by violations of the organic nature of the vessels of the brain or of some other structures located inside the skull.
It would probably be more correct to consider doppler examination of the vessels of the brain not as a diagnostic procedure, which may reveal the correct causes of headache, but as a kind of instrument whose main purpose is to: exclude possible serious pathological abnormalities.
For example - blood clots, arteriovenous, large formations inside the cranial box, various malformations, and others. But, I would like to note that some of the above pathologies are determined far from completely accurate.
What can be learned in the UDC study and when it is used?
With the help of the procedure of the ultrasound of the vessels of the brain it is possible to detect:
- The presence of constriction of the arteries, as well as the degree of their significance.
- In a quantitative version, estimate the speed with which the blood flow in the main arteries located in the neck and head.
- Perform a diagnosis of the presence or absence of vascular aneurysms located in the brain.
- Identify vascular disorders that develop in the early period, first and foremost, it is precisely those that arose as a consequence of atherosclerotic plaques or blood clots.
- Estimate the condition of the arteries of the spine.
- Find out the main reasons why a person feels severe headaches( angiospasms, excessive intracranial pressure, and others).
- Check the state of the venous blood flow of all neck vessels present.
In what situations does Dopplerography of the vessels of the brain and neck apply?
- If the patient has any complaints about headaches or sudden loss of memory.
- With unusual noise in the ears and head.
- In cases where the level of cholesterol is elevated.
- Patients who are overweight.
- With changes occurring in the blood coagulation system.
- If there is a suspicion of certain difficulties of venous outflow from the cranial cavity.
- During dizziness, which is associated with a turning of the head.
- If there is vegetative-vascular dystonia, diabetes mellitus, hypertension, heart attack, or other chronic diseases.
- For cerebrovascular disease, vertebro-basilar insufficiency, stroke, or so-called transient ischemic attack.
- Used as a screening study to evaluate an atherosclerotic lesion of the blood vessels of the heart and brain.
- When the patient's age exceeds 40 years and he has a heart attack or stroke in one of his relatives. The
- is also used to effectively treat and, thus, identify the necessary evidence before a complicated operation.
According to the findings of the data?
The decipherment of the research is based on the comparison of the special calculation parameters of each individual vessel, while taking into account the standard that is standard for it.
So, ultrasound dopplerography of not only transcranial, but also extracranial arterial vessels is capable of evaluating such indices practically on each individual site of each individual artery:
- Diameter of the artery;
- Diastolic velocity;
- The nature and phase of blood flow;
- Artery wall thickness;
- Peak systolic velocity;
- Symmetry of the blood flow on both sides of the artery;
- The state of the artery, which is located next to the stenosis, as well as the degree of state directly to the stenosis itself;
- Resistance indexes, namely, pulsating, resistive, the ratio of systolodialistolic nature.
As for veins, in this case, the nature of blood flow, vascular size, venous wall state, and its derivatives are estimated.
Then measurements are taken at rest and in the period of performance of functional tests, which are compared with the norm. If in any area a pathology is detected, then the sonologist( ultrasound doctor) conducting the survey determines the data using an abbreviation consisting of letters and numbers.
After this, another doctor - a neurologist, has received the necessary results and prescribed a course of treatment for the patient. Of course, such a specialist is well aware of what this or that digit or letter means. Conducted doppler examination of the vessels of the brain will help to understand the angiosurgery or neurologist in what is, in fact, the cause of the disease to which the patient complains.
In addition, the doctor will understand how serious the disease is and how quickly it can develop, as well as what impact the whole process will have on the general state of the brain and other present in the human body skull structures. Thanks to the results obtained, the specialists of the UZDG are guided by how effective the treatment can be.
Decoding the Results of Neurosonography
It looks like the following( it's about situations where all the data are in the normal state):
- Prostate between vessels is mandatory and free and well visible.
- The standard wall thickness of the artery is at least 1 centimeter, borderline, but non-pathological is considered to be within 11-13 millimeters.
- Turbulent blood flow should not be observed in places where there is no branching of vessels.
- Arteriovenous malformations should be completely absent.
- Vessels do not have to squeeze each other, and if this is observed, then such a moment is referred to as signs of compression and appoint an additional course of research.
- All vertebral arteries should have the same diameter, namely about 2 millimeters. The speed with which the blood flow to the sixth vertebra of the neck passes directly through the vertebral veins should not be greater than 0.3 meters per second.
Restrictions that exist when performingUZDG
- Small vessels are much more difficult to evaluate during an ultrasound examination than vessels that are much larger.
- In some situations, the bone of the skull absolutely does not allow to carry out a complete process of studying all the necessary vessels located in the field of the brain.
- The diagnostic value of ultrasound, however, as well as any other diagnostic option( such as mammography, MRI, X-ray, etc.) is directly proportional to the high quality of equipment and, of course, the professionalism of a specialist.
- Ultrasound is not a substitute for angiography but is also a tool used to diagnose vascular disease.
How is the treatment going?
The patient who came to the procedure falls on a special sofa upside down, with the head to be turned left or right and slightly thrown. In order to get a complete picture of the vessels of the brain and neck, sometimes several different modes are applied at once.
B-mode, which is also called two-dimensional. In this version of the study it is solely about the study of vessels that pass outside the cranial box, that is, studying jugular veins, carotid arteries, vertebral arteries, and all other branches that are much smaller in size.
Generally, the following indicators are evaluated: the state of the vessels of the vessels, the permeability of each individual vein and artery, the correct way passes by this or that artery, the condition of tissues, which are actually located near different vessels, the size of vessels.
Color Duplex Scan. Thanks to this method, it is possible to obtain data on the vessels not only in the cavity of the skull, but also on those that are on the neck or around the brain. In this situation, the UDG is called extracranial.
It is thanks to this scan variant that data on the velocity of moving blood flow through the artery, the zones of turbulent blood flow, the homogeneity of the filling of each individual vein or artery, the lumen and many other physiological and additional venous valves, as well as the geometry itself, the state of venous vessels andthe general wall of the vein.