Ультразвуковая допплерография (УЗДГ) — метод, позволяющий оценить скорость движения крови по венам и артериям нижних конечностей, а также проследить изменения направления кровотока.
Что такое УЗДГ?
Ультразвуковая допплерография сосудов нижних конечностей – это метод исследования, при котором можно получить максимум нужной информации, с его помощью врач может оценить состояние кровотока на каждом участке сосудов нижних конечностей. Это позволяет исключить развитие тромбоэмболии и других осложнений варикозного расширения вен.
Важными преимуществами этого метода исследования считаются:
- отсутствие вредного воздействия на организм;
- отсутствие болевых ощущений на момент проведения манипуляции;
- высокая точность показателей;
- доступность процедуры (не высокая цена проведения в частных клиниках);
- возможно проведение исследования для лиц всех возрастных категорий;
- быстрый результат (уже в течение 30мин после обследования специалист сможет оценить информацию и поставить диагноз, что позволит своевременно назначить эффективное лечение);
- не требуется специализированная подготовка перед проведением манипуляции.
Виды ультразвуковой допплерографии
Доплерографическое исследование сосудов насчитывает несколько видов:
- Цветовая. Выявляет характер кровотока сосудов с помощью цвета (красный, синий). Цвет зависит от направления кровотока.
- Энергетическая. При этом методе исследования кровоток на экране окрашивается в желтый или красный цвет в зависимости от скорости тока.
- Импульсно-волновая. С помощью этого вида УЗДГ возможно провести оценку скорости тока крови в сосудах.
- Дуплексное сканирование. Совокупность двух методов исследования методом УЗДГ.
- Триплексная допплерография. Сочетает в себе три метода ультразвуковой допплерографии.
Допплерография нижних конечностей
УЗДГ вен и УЗДГ артерий нижних конечностей очень распространено и проводится чаще остальных.
Допплерография сосудов нижних конечностей помогает оценить состояние их просвета и проходимости тока крови, что очень важно для исключения наличия тромбов.
Обследование сосудов ног требуется проводить людям, страдающим варикозным расширением вен и такими симптомами, как онемение пальцев ног, ощущение слабости в ногах.
Многих людей, страдающих нарушениями кровообращения сосудов ног, интересует вопрос о том, где можно сделать УЗДГ сосудов нижних конечностей. Ответ прост: доплерографическое исследование вен нижних конечностей можно пройти в поликлинике, к которой вы прикреплены (если есть назначение врача и соответствующая аппаратура) или в частных клиниках.
Какие лекарства назначаются для лечения варикоза? Лучшие таблетки, кремы, мази, гели описаны в этой статье.
Специфика проведения манипуляции
Проведение манипуляции напоминает стандартную процедуру УЗИ.
Пациент ложится на кушетку, освободив необходимый для исследования участок тела от одежды. Например, при УЗДГ вен нижних конечностей необходимо снять брюки, колготки и носки. Врач наносит специализированный гель, необходимый для улучшения визуализации. Специалист устанавливает датчик на уровне контрольных точек, необходимых для исследования (точки являются проекцией исследуемого участка сосудов).
При помощи движений датчика и посредством ультразвуковых колебаний, на экране появляется картинка, отображающая необходимые для диагностики данные. Необходимые позы подскажет врач, они зависят от того какой участок необходимо осмотреть. Вся процедура занимает не более 40-45 мин. Затем врач изучает полученные данные и ставит диагноз (это займет от 15 до 30 мин). Результат выдается на руки в виде напечатанного или написанного вручную заключения специалиста.
Показания к проведению
Ультразвуковая допплерография применяется для диагностики следующих заболеваний:
- перепады кровяного давления (процедура проводится как при гипертензивных, так и при гипотонических проявлениях);
- частые головные боли (мигрени);
- стенокардия (а также все проявления сердечно-сосудистых заболеваний);
- онемение конечностей;
- ощущение шума в голове;
- шум в ушах;
- повышенная раздражительность;
- после перенесенной ЧМТ;
- синдром Рейно;
- стремительная потеря зрения;
- бессонница без явных причин;
- варикоз;
- аневризма сосудов;
- неоднократная потеря сознания или другие симптомы нарушений работы мозга.
При признаках нарушения кровообращения головного мозга назначают УЗДГ БЦА.
УЗДГ БЦА — что это такое? Это метод исследования брахиоцефальных артерий. Назначается как правило при патологиях сосудов головы или шеи.
Противопоказания
Метод УЗДГ очень безопасный для организма человека и серьезных препятствий для проведения манипуляции нет. Противопоказанием можно считать невозможность принятия необходимого для исследования положения в связи с физиологическими особенностями пациента. Невозможность его транспортировки к месту проведения исследования.
Интерпретация результатов процедуры
Расшифровать данные, полученные в результате обследования, может только специально обученный врач-диагност.
Основные принципы исследования состоят в том, чтобы выяснить состояние стенок сосуда и тока крови в нем.
Диагностика методом УЗДГ позволяет оценить скорость кровотока в каждом конкретном сосуде (для каждого сосуда имеется своя норма).
Индекс пульсации. Вычисляют средний показатель скорости тока крови и от него определяют амплитуду от самого высшего значения до наименьшего.
При рассматриваемом методе обследования сосудов есть возможность узнать толщину сосудов (норма составляет от 0.9 до 1.1 мм). Позволяет диагностировать стеноз сосудов (сужение просвета).
Расшифровка дуплексного сканирования брахиоцефальных артерий
Интерпретация исследования сосудов головы и шеи практически не отличается от других. Просматривается симметричность артерий, наличие или отсутствие стеноза сосудов. Кровоток вен шеи не должен превышать 0.3 м/с. Диаметр артерий позвонка должен составлять 2 мм или немного больше.
Точность результатов манипуляции составляет от 70 до 90%. Этот способ диагностики состояния сосудов и скорости кровотока в них очень распространен ввиду простоты проведения, точности показателей и отсутствия долгой подготовки.
Из этой статьи вы узнаете, как проводят УЗДГ сосудов нижних конечностей, кому назначают процедуру. Что можно диагностировать с помощью УЗДГ.
Автор статьи: Стоянова Виктория , врач 2 категории, заведующая лабораторией в лечебно-диагностическом центре (2015–2016 гг.).
УЗДГ – это ультразвуковая допплерография. Этот метод диагностики, в отличие от других способов обследования сосудов, способен показать скорость кровотока, что позволяет точно диагностировать степень тяжести заболевания, нарушающего кровообращение.
Для любых сосудов эта процедура проводится по одному и тому же принципу – с помощью УЗ-датчика, как и любое УЗИ. Чаще эта процедура требуется для обследования вен, для исследования артерий ее используют реже.
На это обследование вас могут направить разные врачи: терапевт, флеболог, ангиолог. Проводит процедуру специалист ультразвукового исследования.
Показания
УЗДГ сосудов ног назначают для диагностики таких заболеваний:
- Варикозное расширение вен.
- Тромбофлебит.
- Атеросклероз.
- Тромбоз.
- Спазм артерий ног (ангиоспазм).
- Аневризмы артерий (их расширения).
- Облитерирующий эндартериит (воспалительное заболевание артерий, которое приводит к их сужению).
- Артериовенозные мальформации (патологические соединения между артериями и венами).
При каких симптомах назначают УЗДГ
На эту диагностическую процедуру пациентов направляют при подозрении на сосудистые заболевания ног. Врач может назначить вам УЗДГ, если вы испытываете такие симптомы:
- отеки ног;
- тяжесть в ногах;
- частое побледнение, покраснение, посинение ног;
- «мурашки», онемение в ногах;
- боли при ходьбе менее чем на 1000 метров;
- судороги в икроножных мышцах;
- сосудистые «звездочки», «сетки», выпячивающиеся вены;
- склонность к замерзанию ног, холодные ноги, даже когда тепло;
- появление синяков на ногах даже после малейшего удара или же вообще без причины.
Когда нужна профилактическая допплерография
Проходите допплерографию сосудов ног в профилактических целях раз в полгода-год, если вы находитесь в группе риска. К заболеваниям сосудов нижних конечностей склонны:
- люди с лишним весом;
- занятые физическим трудом (грузчики, спортсмены);
- те, кто постоянно стоит или много ходит на работе (учителя, охранники, курьеры, официанты, бармены);
- те, кому уже диагностировали атеросклероз других сосудов;
- люди, чьи прямые родственники страдали сосудистыми заболеваниями;
- те, у кого сахарный диабет;
- курильщики;
- люди старше 45 лет;
- женщины в периоды беременности и менопаузы;
- женщины, принимающие оральные контрацептивы долгое время.
Подготовка
Процедура не требует какой-либо сложной подготовки.
Единственное – ноги должны быть чистыми. Если у вас ввиду индивидуальных особенностей густой волосяной покров на ногах, желательно его сбрить, чтобы врачу было легче работать.
В день процедуры не пейте алкоголь, стимулирующие напитки (кофе, крепкий чай, энергетики), не подвергайте ноги физическим нагрузкам (не бегайте, не поднимайте тяжести, не ходите на тренировки). За 2 часа до УЗДГ сосудов нижних конечностей (и других сосудов тоже) не курите. Лучше идти на обследование с утра.
Возьмите с собой на процедуру салфетки или полотенце, чтобы потом вытереть ноги. Также принесите направление на УЗДГ от вашего врача и результаты предыдущих обследований сосудов.
Как проводят исследование
Сначала вы освобождаете ноги от одежды.
Обследование будет проводиться стоя или лежа. Врач наносит гель для ультразвукового исследования и водит УЗ-датчиком по ногам.
Изображение ваших сосудов выводится на монитор специалиста. Сразу по ходу выполнения процедуры он анализирует и записывает полученные данные.
Если вас будут обследовать лежа, то сначала врач скажет вам лечь на живот и приподнять ноги на носочки. Или же можно подложить под стопы валик. В такой позиции специалисту наиболее удобно обследовать подколенную, малоберцовую, малую подкожную и суральные вены, а также артерии задней поверхности ног. Затем вас попросят перевернуться на спину и чуть-чуть согнуть ноги в коленных суставах. В этом положении врач может исследовать вены и артерии передней поверхности ног.
Анатомия вен ног. Нажмите на фото для увеличения
Во время проведения УЗДГ для выявления рефлюксов (обратного сброса крови) врач может выполнить специальные пробы:
- Компрессионную пробу. Конечность сдавливают и оценивают кровоток в сжатых сосудах.
- Пробу Вальсальвы. Вас попросят вдохнуть, зажать нос и рот и чуть натужиться, пытаясь выдохнуть. Если есть начальная стадия варикозного расширения вен, рефлюкс может проявиться во время проведения этой пробы.
На допплерографию сосудов в общей сложности уходит около 10–15 минут.
По окончании обследования вы вытираете ноги от остатков геля для УЗИ, одеваетесь, забираете результат и можете идти.
Что показывает УЗДГ сосудов ног
С помощью допплерографии нижних конечностей можно обследовать такие сосуды ног:
| Вены | Артерии |
|---|---|
| Бедренную, подколенную, большую и малую подкожные, суральные, поверхностную огибающую подвздошную, передние берцовые, тыльную подошвенную венозную дугу, заднюю арочную вену, перфорантные вены. | Подвздошную, бедренную, подколенную, большую берцовую, артерии стопы. |
Ответвления этих крупных артерий.
Во время проведения этой диагностической процедуры врач может увидеть:
- форму и расположение сосудов;
- диаметр просвета сосуда;
- состояние сосудистых стенок;
- кондицию артериальных и венозных клапанов;
- скорость кровотока в ногах;
- наличие рефлюкса (обратного сброса крови, который часто встречается при варикозном расширении вен);
- присутствие тромбов;
- размер, плотность и структуру тромба, если он есть;
- наличие атеросклеротических бляшек;
- присутствие артериовенозных мальформаций (соединений между артериями и венами, которых в норме быть не должно).
Нормы УЗДГ, заключение с пояснениями
Вены должны быть проходимые, не расширенные, стенки не утолщенные. Просветы артерий не сужены.
Все клапаны должны быть состоятельными, рефлюксов быть не должно.
Скорость кровотока в бедренной артерии в среднем составляет 100 см/с, в артериях голени – 50 см/с.
Атеросклеротических бляшек и тромбов в сосудах не должно быть выявлено.
Патологические соединения между сосудами в норме отсутствуют.
Пример нормального заключения УЗДГ вен ног и пояснения к нему
Заключение: все вены с обеих сторон проходимы, компрессивны, стенки не утолщены, кровоток фазный. Внутрипросветных структур не выявлено. Клапаны состоятельны на всех уровнях. Патологические рефлюксы при выполнении компрессионных проб и пробы Вальсальвы отсутствуют.
| Тезисы из заключения | Что они означают |
|---|---|
| Все вены с обеих сторон проходимы, компрессивны, стенки не утолщены. | Все вены с обеих сторон проходимы – означает, что кровь может беспрепятственно течь по сосудам. Компрессивны – то есть не потеряли свой естественный тонус, могут сжиматься. Стенки не утолщены – это свидетельствует о том, что нет никаких воспалительных и других патологических процессов. |
| Кровоток фазный. | Кровоток фазный – быстрее на выдохе и медленнее на вдохе. Таким он должен быть в норме. |
| Внутрипросветных структур не выявлено. | Внутрипросветных структур не выявлено – отсутствуют атеросклеротические бляшки, тромбы и другие включения, которых там быть не должно. |
| Клапаны состоятельны на всех уровнях. | Клапаны состоятельны – то есть нормально выполняют свои функции и не допускают обратного тока крови. |
| Патологические рефлюксы при выполнении компрессионных проб и пробы Вальсальвы отсутствуют. | Патологические рефлюксы при выполнении проб отсутствуют – кровь ни при каких обстоятельствах не сбрасывается в обратном направлении, что говорит о здоровом кровообращении. |
Противопоказания
Допплерография сосудов нижних конечностей – абсолютно безопасная процедура. Она не имеет противопоказаний и ограничений по возрасту.
Ее можно проводить с любой частотой и любым людям, в том числе:
- детям любого возраста;
- пожилым;
- людям с хроническими заболеваниями;
- пациентам с острыми воспалительными заболеваниями;
- тем, кому имплантирован кардиостимулятор (направлять УЗИ-датчик на ноги им можно, а УЗИ органов грудной полости делать нельзя);
- беременным и кормящим женщинам;
- тем, у кого аллергия на контрастные вещества (ангиографию, например, в этом случае выполнить невозможно);
- людям с весом более 120 кг (а вот провести МРТ тучным пациентам на большинстве аппаратов невозможно, так как они не рассчитаны на такие габариты).
Единственное ограничение, которое можно допустить, – это аллергия на гель для УЗИ. Она встречается в единичных случаях. И она не является абсолютным противопоказанием к выполнению диагностики. Аллергической реакции можно избежать, подобрав гипоаллергенный гель, который подходит именно вам.
Гель для проведения УЗИ
Резюме, плюсы процедуры
Допплерография сосудов нижних конечностей – абсолютно безболезненный способ диагностики. Он не вызывает никаких побочных эффектов и не имеет противопоказаний (за исключением аллергии на гель для УЗИ). Как показывают исследования ученых, ультразвуковые волны не наносят никакого вреда организму, поэтому УЗИ сосудов ног может проводиться с любой частотой.
В отличие от МРТ, УЗДГ не имеет ограничений по весу пациента и может выполняться людям с установленным кардиостимулятором.
Эту процедуру можно выполнить пациентам с аллергией на контрастные вещества и другие йодсодержащие препараты, чего не скажешь об ангиографии и контрастной флебографии.
Среди плюсов можно отметить и низкую стоимость. Допплерография стоит ощутимо дешевле, чем МРТ, ангиография и флебография.
К неоспоримым преимуществам метода относится и быстрота выполнения. УЗДГ делают максимум за 15 минут. На МРТ, например, уходит не менее получаса.
Можно сказать, что допплерография – самый оптимальный метод обследования сосудов из существующих на сегодняшний день. Он сочетает в себе высокую точность, доступную стоимость, высокую скорость проведения и практически полное отсутствие противопоказаний.
Ультразвуковая допплерография (УЗДГ) считается одним из наиболее эффективных методов диагностики. С ее помощью можно получить точную информацию о скорости и направлении кровотока, о состоянии сосудов верхних и нижних конечностей.
Благодаря такому обследованию врач быстрее сможет установить диагноз и назначить соответствующее лечение. В клиниках «Альфа-Центр Здоровья» в Москве и 11 городах России УЗДГ нижних конечностей проводится с использованием современного оборудования, позволяющего заметить самые незначительные изменения в состоянии сосудов.
Преимущества обращения в клинику «Альфа-Центр Здоровья»
- Быстрый результат. В клиниках «Альфа-Центр Здоровья» пациенту не нужно долго ждать, чтобы попасть на прием к врачу. Достаточно прийти в назначенное время.
- Точные данные. Специалисты клиники имеют большой опыт в проведении УЗДГ. Вместе с современным оборудованием это позволяет получать необходимые данные о состоянии вен и артерий, чтобы поставить точный диагноз.
- Комплексные услуги. Иногда для постановки диагноза помимо допплерографии нижних конечностей требуется консультация узких специалистов. В клинике «Альфа-Центр Здоровья» можно в этот же день записаться на прием к профильному врачу.
- Комфорт при посещении врача. В клинике «Альфа-Центр Здоровья» к каждому пациенту мягкое и доброжелательное отношение. Наши специалисты найдут подход и к ребенку, и к пожилому человеку.
- Выгодная стоимость услуг. Цена на УЗДГ вен и артерий нижних конечностей остается на доступном уровне во всех городах присутствия клиники.
В чем заключается суть метода
УЗДГ основана на эффекте Доплера. Ученый смог установить, что от движущихся объектов (например, крови) УЗ-волны отражаются с измененной частотой. Если на сосуды прицельно направить ультразвуковые волны, можно узнать, с какой скоростью и в каком направлении течет кровь, обнаружить участки расширения и сужения. УЗДГ сосудов нижних конечностей проводят в трех режимах:
- В-режим. Изображение исследуемой области на экране черно-белое. Специалист измеряет диаметр сосуда, толщину его стенок, выявляет внутренние образования и оценивает состояние венозных клапанов.
- Цветовой режим. Исследуемый сосуд на экране имеет определенный оттенок. В месте нарушения кровотока цвет меняется, что позволяет точно определить локализацию патологии.
- Спектральный режим. Данные об исследуемом кровеносном сосуде выводятся на экран в виде спектрограммы, на которой отображены основные характеристики кровотока.
Специалисты клиники «Альфа-Центр Здоровья» часто используют несколько режимов допплерографии во время обследования пациента. Это позволяет получить точные данные.
Когда требуется УЗДГ нижних конечностей
УЗДГ артерий и вен нижних конечностей проводят при подозрении на атеросклероз. Обследование назначается всем пациентам, которым уже поставили диагноз «тромбоз», «ангиопатия», «варикозное расширение вен» и других случаях, связанных с патологиями сосудов. Это необходимо для оценки эффективности назначенной терапии и наблюдения за развитием патологического процесса. Допплерография сосудов нижних конечностей в комплексной диагностике может быть показана при следующих состояниях:
- Боль или судороги в икроножных мышцах.
- Отеки нижних конечностей.
- Чувство тяжести, онемения или жжения в ногах.
- Изменения цвета кожных покровов, их сухость или зуд.
- Появление сосудистых сеточек.
- Выпячивание расширенных вен.
- Перемежающаяся хромота.
- Ожирение.
Как подготовиться к процедуре
Подготовка перед УЗДГ вен и артерий нижних конечностей не нужна. Достаточно будет записаться на обследование у врача и прийти к указанному времени. Если ранее вы уже проходили подобную процедуру, желательно иметь ее результаты при себе, чтобы специалисты клиники «Альфа-Центр Здоровья» смогли отследить динамику произошедших изменений.
Как проводится обследование
Для прохождения УЗДГ вен и артерий нижних конечностей пациент ложится на кушетку на спину или живот. Перед началом обследования на кожу в области исследования наносят проводящий гель. Датчик перемещают по коже, а изображение вен и артерий отображается на экране. В ходе исследования врач может попросить изменить положение тела, напрячь мышцы. Это позволит получить точные сведения о венах и артериях, изучить особенности движения крови.
Противопоказания для проведения исследования
К допплерографии нижних конечностей практически нет противопоказаний. Процедура безболезненная и безопасная. Диагностику с помощью допплерографии проводят даже беременным женщинам и детям, не опасаясь негативных последствий. УЗДГ не назначается только пациентам в тяжелом состоянии, если они не могут принять необходимую позу.
Временным противопоказанием к допплерографии служат различные повреждения и дефекты кожи на ногах, которые могут помешать плотному прилеганию ультразвукового датчика к поверхности тела. При ранах, ссадинах, царапинах достаточно дождаться их заживления, чтобы пройти обследование. При наличии более серьезных препятствий может быть рекомендован альтернативный способ диагностики. Об этом следует поговорить с лечащим врачом.
Чтобы записаться на обследование, уточнить цену, график приема врачей, обратитесь к специалистам нашего call-центра. Они ответят на все ваши вопросы.
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