Doppler ultrasound of the vessels of the head and neck (Doppler ultrasound): what is it

The human brain requires continuous nutrition and a timely outflow of blood. These functions are performed by the system of great vessels of the neck and head, the pathologies of which cause dangerous diseases.

The carotid and vertebral arteries provide food, and the jugular veins collect and transport blood back to the heart.

The importance of timely diagnosis of these and other vessels of the head and neck lies in the fact that nerve cells are very sensitive to any disturbances in blood flow.

A common diagnostic method is ultrasonography of the vessels of the head and neck, which is an ultrasound Doppler ultrasonography of the extracranial and intracranial vessels.

What is USDG?

The essence of the method lies in the combination of ultrasound with Doppler ultrasound, which provides a number of advantages, which include the assessment of hemodynamics, patency and geometry of blood vessels.

The sensors create high frequency sound waves that are reflected from the cellular elements of the blood and are absorbed by the pulse shaping device.

The doctor works with the final indicators - images, graphs, diagrams.

The method has access to the vessels of different parts of our body, but most often the doctors refer the patient to the USDG vessels of the head and neck, as this makes it possible to comprehensively analyze the blood supply to the head brain.

Doppler ultrasonography of the vessels of the head and neck is a reliable screening examination that detects abnormalities and diseases at the initial stages, which makes it possible to save the lives of many patients. The procedure does not cause pain, complex preparation by the patient is not required.

For what diseases is USG indicated?

Indications for Doppler sonography of the vessels of the head and neck can be both disorders of the nervous system and other systems of the body. The procedure is assigned to people when they identify:

• carried over stroke or heart attack;
• diseases associated with hypoxia of brain tissue;
• cranial trauma, neck injury;
• cervical osteochondrosis;
• high blood pressure;
• diabetes mellitus;
• angioedema;
• seizures;
• perinatal encephalopathy;
• cerebrovascular diseases;
• acute and chronic hypoxia of the brain;
• pathology of the vestibular apparatus;
• severe hearing impairment;
• angina;
• high cholesterol;
• violation or asymmetry of the pulse of the extremities.

For what complaints dopplerographic examination of blood vessels is prescribed

In addition to diseases and pathological conditions, when prescribing an ultrasound scan of the head and neck, the doctor relies on the patient's complaints, indicating the presence of some symptoms:

• headache, migraine with aura, BPPV and dizziness;
• vision problems, temporary one-sided blindness;
• fast fatiguability, asthenic syndrome;
• gait problems myasthenia gravis, bulbar palsy, or numbness of the limbs;
• violation of consciousness;
• lack of air;
• fainting;
• insomnia;
• weakness.

What is being evaluated?

Doppler ultrasound of the neck vessels analyzes the work of the extracranial arteries and veins involved in the nutrition of the brain and blood deposition.

The work of the intracranial arteries and veins is shown by the transcranial USDG.

These studies are often carried out simultaneously to increase the information content of the study. In this case, the doctor is interested in the following:

• Velocity characteristics of hemodynamics;
• Vessel structure;
• The direction of the passage of the vessel;
• Obstructed lumen visualization range;
• The presence of an aneurysm, narrowing (stenosis), venous thrombosis and other vascular pathologies;
• Characterization of adjacent tissues;
• Adequacy venous outflow.

Not all anatomical formations are available for analysis using USDG of the vessels of the head and neck, but key vascular beds fall into the field of view of the diagnostician. These include:

• Vertebral vessels;
• Carotid arteries;
• Subclavian vessels;
• Basillar artery;
• Jugular veins;
• Intracerebral arteries.

How to prepare for the examination?

The patient should refrain from drinking tea, coffee, energy and alcoholic drinks 24 hours before the ultrasound scan.

It is not recommended to smoke less than four hours before the examination and take medication. The meaning of these restrictions is not to create unnecessary stress on blood vessels in particular and blood pressure in general.

If a child is being examined, it is necessary to provide him with physical and emotional peace. The child must understand that the procedure is painless and he will need to comply with the doctor's requirements, not speak or make unnecessary movements.

The doctor may ask the child to start breathing quickly or hold their breath. For babies under one year old, it is recommended to feed an hour before the procedure and to ensure sleep.

There are no restrictions on food consumption the day before, but there are no follows, since in the process of digesting food, blood flow to the head decreases, which can distort study.

For hygiene reasons, it is recommended to take a towel with you.

How is Doppler ultrasound performed?

Doppler ultrasound is quick and painless, usually 50 minutes is enough.

The patient frees the head and neck from all that is superfluous and lies on his back. I put a roller under the neck to prevent squeezing of blood vessels.

The doctor uses an ultrasound sensor that directs ultrasonic vibrations into the vascular cavity, where they are reflected from moving blood cells.

The sensor records the reflected waves and transmits the signal to the computer, where a complete picture is formed during the examination.

The distortion of the reflection of ultrasound from moving objects describes the Doppler effect. Vessels with stopped blood flow do not have this effect.

For better contact of the sensor with the skin, a special gel is applied to the study area. During the ultrasound scan of the neck vessels, the gel is applied directly to the neck to visualize the extracranial vessels.

Transcranial ultrasound scan involves the application of a gel in certain places:

• The back of the head;
• Temple;
• The area above the eye sockets.

The temporal bones are used by the ultrasound diagnostician as a kind of "window" where ultrasonic waves can more easily overcome the bone tissue.

The diagnostician uses functional tests to clarify the state of the vascular bed. These include:

• Test with a head turn to clarify the relative position of the vertebra and the adjacent vessel;
• Hyperventilation, holding your breath;
• Finger pressing of the vessel;
• Taking vasoactive medications.

Sometimes, due to the position of the patient, an urgent diagnosis is required with an interpretation of the result. For this purpose, portable Doppler devices with a simplified technique are used.

When ultrasonic waves are reflected from blood cells, sounds appear, the nature of which gives an idea of ​​the hemodynamics in the vessel. This method allows the ultrasound scan to be carried out directly at the patient's bedside.

Immediately after the end of the procedure, the doctor who conducted the study can comment on the patient's condition, based on the images, graphs and diagrams obtained. The final diagnosis based on these results is made by the doctor who referred the patient for Doppler ultrasonography.

Interpretation of results

Arteries and veins are examined in order, and the results are recorded with specific labels. The attending physician is interested in certain characteristics:

• Arterial wall thickness;
• Pulse index;
• Hemodynamic speed;
• Systole-diastolic ratio;
• Narrowing of the vessel and its degree;
• The diameter of the vascular bed;
• The nature of hemodynamics.

Some normal indicators:

• Arterial wall thickness within 0.9-1.1 mm;
• Free vessel lumen without atherosclerotic changes;
• Laminar blood flow if there are no branches of the vessel nearby;
• The diameter of the vertebral arteries is from 2 to 4 mm;
• No blockage or stenosis of the vessel;
• The length of the common carotid artery is 10-15 cm. left and 7-12 cm. on right.

The doctor compares the indicators with the norm and, on the basis of these data, analyzes the features of the blood supply to the brain, finds the cause of the pathology in individual arteries and veins.

What are the contraindications

Doppler ultrasonography of the vessels of the head and neck is minimally invasive and safe, there are no serious restrictions.

The study can be difficult if the vessel is closed by bone or a thick layer of subcutaneous fat in obese people.

The procedure is not performed if there is a wound in the study area.

What pathologies does ultrasonography diagnose?

The defeat of the aortic arch and its intracranial branches plays a leading role in the formation of hypoxia of brain tissue, ischemic stroke, discirculatory encephalopathy.

A large percentage of people at the doctor's appointment complain of a headache, the occurrence of which is often rooted in functional or organic changes in the vascular system of the head and neck.

With all the advantages, the Doppler ultrasound method does not replace angiography and, moreover, magnetic resonance imaging. The USDG method perfectly visualizes large great vessels, but is less useful in the study of small arteries and veins.

Doppler ultrasound and patient age

Elderly people are advised to have a head and neck ultrasound scan even if there are no complaints.

This is associated with an increased risk of developing vascular diseases such as atherosclerosis, arterial hypertension, coronary heart disease, myocardial infarction and stroke.

You should talk to your doctor about the need for such a study.

The method is also important in childhood.

Doppler ultrasound detects congenital anomalies and pathologies of the vascular bed, which can seriously affect the development of a child at the earliest stages. The same applies to pregnant women who are also diagnosed.

In children, it emits specific symptoms that are an alarming signal:

• Frequent headaches;
• Dropsy;
• Dizziness;
• Capriciousness, restlessness;
• Bad sleep;
• Refusal to eat in infants;
• Problems with the development of speech;
• Problems with short-term and long-term memory.

For parents children 7-18 years old vigilance should be exercised - in this age group, angoidystonic disorders are common.

A study of the blood supply to the brain of such children will help to identify early manifestations of migraine, epilepsy, logoneurosis, hearing loss, vegetative vascular dystonia, myopia and other diseases.

Video how the procedure is carried out