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Ультразвуковая допплерография артерий нижних конечностей

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17 августа 2019

УЗДГ (ультразвуковая допплерография) артерий нижних конечностей – это современный вид комплексной диагностики верхнего пояса с помощью ультразвука, который основан на эффекте Допплера. Этот метод применяется для получения качественной и одновременно количественной характеристики состояния сосудистой системы ног. Допплерография признана самым быстрым, информативным и безболезненным способом проверки состояния кровоснабжения нижних конечностей, которое позволяет выявить характер кровотока в кровеносных сосудах любого размера.

Ультразвуковое исследование артерий нижних конечностей является неинвазивным, безопасным и весьма эффективным диагностическим инструментом. Поскольку во время обследования организм не подвергается лучевой нагрузке, УЗДГ не имеет абсолютных противопоказаний и ограничений. По показаниям УЗДГ артерий нижних конечностей детям, в том числе новорожденным, можно делать в любом возрасте. Относительным ограничением для проведения диагностики является нарушение кожного покрова исследуемой области.

Показания

УЗДГ артерий нижних конечностей позволяет достоверно определить следующие данные: скорость кровотока; деструктивные изменения сосудов вследствие воспалительных или атеросклеротических процессов; аномалии, в том числе нарушение проходимости и патологическая извилистость сосудов. УЗДГ артерий ног назначают при спазме, аневризмах и воспалительных заболеваниях артерий ног, которые приводят приводит к их сужению, а также в случае патологических соединений между артериями и венами.

Подготовка

Никакой специальной подготовки к УЗДГ артерий нижних конечностей не требуется. Пациент занимает на кушетке комфортное положение и обеспечивает врачу доступ к области, где будет проводиться диагностика. Как правило, обследование длится 15-20 минут.

Cтоимость уздг артерий нижних конечностей в Москве составляет от 1600 до 23951 рублей. Средняя цена составляет 3100 рублей. Самые дешевые варианты здесь.

Где сделать УЗДГ артерий нижних конечностей?

На нашем портале собраны все клиники, где вы можете сделать УЗДГ артерий нижних конечностей в Москве. Выберите клинику, подходящую по цене и местоположению, и запишитесь на прием на нашем сайте или по телефону.

Заболевания сосудистого русла часто приводят к значительному снижению качества жизни и трудоспособности пациентов. Также они могут быть предпосылками к развитию ряда опасных осложнений.

Поэтому идет активная разработка профилактических мероприятий по выявлению факторов, повышающих вероятность их возникновения. Один их лучших диагностических методов — УЗДГ сосудов нижних конечностей.

Он относится к неинвазивным процедурам, полностью безопасен и может быть проведен в большинстве больниц.

Это исследование бывает очень полезным для проверки функции сосудов в случае стенозирующего атеросклероза периферических артерий. Также оно применяется для поиска возможных источников тромбоза и определения риска эмболии.

Как происходит допплерографическое исследование

Процедура проводится так же, как и стандартная ультразвуковая диагностика. Пациента приглашают в отдельный комфортный кабинет, где расположено необходимое оборудование. Его просят снять брюки или другую одежду, которая может мешать работе УЗИ-аппарата, после чего он ложится на кушетку.

Желательно как можно меньше двигаться и ерзать.

Это интересно! Никакая специальная подготовка пациента перед УЗДГ не требуется, что крайне удобно.

Врач наносит на область, которую следует осмотреть, специальный гель, облегчающий проникновение ультразвуковых волн, после чего и проводится непосредственное обследование при помощи специального датчика, прикладывая его в нужных местах к коже и придавая ему определенное положение.

Этот прибор регистрирует затухание и изменения характеристик волн и отправляет их на компьютер, где и происходит обработка и анализ этих данных.

Метод основан на том, что при прохождении через ткани и движущиеся потоки жидкости, например, крови в сосудах, частота и направление ультразвуковой волны меняются определенным образом.

Специальные устройства улавливают и регистрируют их, после чего с помощью специального алгоритма компьютер строит модель, отображающую строение той части тела, сквозь которую проходили волны. Все это в конечном итоге преобразуется в результирующее изображение и выводится на экран.

Врач изучает его и смотрит, каково состояние сосудов в исследуемой области, какие скорость и направление тока крови в артериях или венах. С помощью УЗИ вен можно обнаружить несостоятельность венозных клапанов, что является причиной тромбофлебитов и подобных заболеваний.

Это интересно! Эта методика показывает и сами тромбы, что играет крайне важную роль в диагностике вторичных тромбоэмболий.

Когда проводят допплерографию

Основная цель исследования сосудов ног – оценить проходимость основных артерий и вен у взрослого, а также с помощью УЗИ можно проверить наличие тромбов в их просвете.

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Это важно при следующих патологиях:

  • Стенозирующем атеросклерозе нижних конечностей.
  • Тромбофлебите глубоких вен ног.
  • Легочной тромбоэмболии.
  • Мезентериальном тромбозе.
  • Тромбозе нижней полой вены.

При тромбофлебите происходит замедление тока крови в венах, развивается ее застой. В результате этого сосудистая стенка воспаляется, в результате чего создаются благоприятные условия для формирования пристеночных тромбов.

Однако, со временем они могут крошиться. Кусочки тромбов с током крови могут заноситься в легкие, кишечник и закупоривать там мелкие сосуды, вызывая острую ишемию и даже гибель тканей. Это состояние называется тромбоэмболией.

Грозные симптомы

В случае поражения легочных сосудов пациенты жалуются на:

  • Выраженную одышку, что возникает на фоне полного благополучия.
  • Сильную слабость.
  • Чувство нехватки воздуха.
  • Помутнение зрения, ощущение сетки перед глазами.
  • Учащенное, поверхностное дыхание.
  • Частое сердцебиение, ослабленный, нитевидный пульс.
  • Влажный кашель, иногда – с отхождением белой мокроты с прожилками крови.

Мезентериальный тромбоз характеризуется следующими проявлениями:

  • Резкая, выраженная боль в животе.
  • Сильная тошнота и рвота, которая не приносит пациенту облегчения.
  • Сильная диарею, иногда – с частичками крови.
  • Учащенный пульс.

При выявлении этих симптомов следует как можно скорее оказать квалифицированную помощь пациенту. Поскольку эти болезни могут возникнуть внезапно, без каких-либо предпосылок, важную роль играет их профилактика.

Именно поэтому пациентам с тромбофлебитом рекомендуют регулярно делать обследование. Оно помогает определить риск тромбозов и подобрать профилактическую медикаментозную терапию, которая поможет обезопасить жизнь больных.

Для точной постановки и документального подтверждения диагноза этим больным необходимо провести ультразвуковое обследование предполагаемых источников тромбоза. Это также определяет дальнейшую тактику лечения – после стабилизации состояния может понадобиться хирургическое вмешательство, которое позволит предотвратить повторные эмболии.

Важно! Отказываться от профилактики не стоит, ведь эмболия развивается стремительно, и скорая может попросту не успеть вовремя доехать до пациента в тяжелом состоянии.

Также процедура рекомендована пациентам, страдающим сахарным диабетом, ведь эта болезнь способствует быстрому повреждению сосудистого эндотелия молекулами глюкозы, что приводит к развитию атеросклероза и тромбозов.

В результате этого у них быстро появляется выраженный артериальный стеноз, из-за чего развивается ишемическое поражение ног и стоп. Проводится оно и после хирургических вмешательств, для оценки эффективности операции и риска послеоперационных осложнений.

Когда еще УЗДГ оказывается полезной?

Допплерография является одним из наиболее эффективных методов исследования артерий и вен шеи, а также сосудов, кровоснабжающих головной мозг. Она позволяет оценить их пропускную способность, обнаружить сужение или атеросклеротическую бляшку.

При помощи данной методики можно легко и довольно точно определить, где именно находится патологическое образование, каковы его размеры, а также измерить скорость местного кровотока.

Это актуально для пациентов, которые страдают от выраженного атеросклероза периферических сосудов, и жалуются на головные боли, головокружение, чувство непонятной слабости и неустойчивости.

Также показаниями к исследованию являются ухудшение памяти без видимых причин, забывчивость, быстрая утомляемость и нервные срывы.

Помните! Все это может быть следствием плохой проходимости сосудов шеи и головы, что приводит к ишемии нервной ткани головного мозга.

Именно на основании данных ультразвукового исследования сосудистые хирурги принимают решение о целесообразности и тактике инвазивного лечения атеросклероза сонных артерий.

Если бляшка большая и сильно перекрывает просвет сосуда, вызывая выраженное нарушение самочувствия, и может стать причиной еще больших осложнений, то возможна постановка специальных стентов, которые раздвигают стенки бляшки и облегчают ток крови к голове.

УЗДГ сосудов нижних конечностей позволяет получить достаточно много информации о состоянии сердечно-сосудистой системы. С помощью этого исследования врачи могут точно определить нарушен ли кровоток или нет, а также визуализировать имеющиеся в сосудистом просвете тромбы или атеросклеротические бляшки. После этого принимается решение относительно назначения тех или иных препаратов или процедур.

Поэтому данное обследование показано многим пациентам, страдающими сахарным диабетом, атеросклерозом, тромбофлебитом.

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Также УЗДГ проводится больным с подозрением на тромбоэмболические осложнения в виде легочного или мезентериального тромбозов – это необходимо для подтверждения диагноза и обнаружения источника эмболии. Коррекция терапии и дальнейшее лечение также проводится с учетом этих данных.

Не следует пугаться сложного названия этой процедуры – она совершенно безопасна и безболезненна. Исследование относится к классу неинвазивных, поэтому никакого вмешательства в организм не потребуется, врачи используют лишь внешний датчик.

При этом организм не подвергается воздействию рентгеновского облучения, что выгодно отличает ультразвуковое исследование от лучевых методов диагностики. Поэтому его можно проводить даже беременным и кормящим матерям.

Ультразвуковая допплерография – доступный, высокоинформативный и безболезненный метод диагностики. С ее помощью можно на ранних стадиях выявить заболевания и патологии крупных и средних сосудов человеческого тела.

Допплеровское исследование проводят для изучения характеристик кровотока, при подозрениях на нарушения структуры и функционирования артерий, вен, для прогнозирования возникновения тех или иных заболеваний.

Большинство пациентов, которым назначают допплерографию, примерно представляют себе, что такое УЗИ, но не знают, что такое УЗДГ, и чего можно ожидать от этой процедуры.

Почему для изучения сосудов применяют именно УЗДГ

Для того, чтобы понять, почему для диагностики артерий, вен и кровотока используют именно ультразвуковую допплерографию, нужно разобраться, что же такое УЗДГ? А также чем она отличается от обычного УЗИ.

Стандартная ультразвуковая диагностика позволяет оценить состояние тканей человеческого тела, находящихся в состоянии относительного покоя. А УЗИ с допплерографией делается в случае, если нужно проанализировать характеристики движущихся объектов – кровяных клеток и кровотока в целом.

Метод основан на «эффекте Допплера» – способности определенного ультразвукового луча проходить сквозь неподвижные ткани, но отражаться от объектов, находящихся в движении. Анализ показателей делается на основании частоты сигнала, которая меняется в зависимости от характера и направленности движений объектов. В природе по такому же принципу работают органы чувств летучей мыши.

УЗИ и УЗДГ делаются на одном аппарате. Когда проводится допплерометрия, традиционное УЗИ является ее первым этапом.

Сначала специалист с помощью В-режима (обычное УЗИ) оценивает состояние самих сосудов. А затем аппарат переключается на другой режим и проводится доплеровское исследование кровотока. В результате такого комплексного подхода врачи могут наиболее точно оценить состояние артерий и вен, а также определить скорость, направление, объем циркулирующей по ним крови.

  • Наиболее информативный метод диагностики образования проблем в сосудах. Некоторые патологии вен и артерий можно выявить исключительно при помощи допплерографии.
  • Не инвазивный и не болезненный метод. Не имеет противопоказаний и побочных эффектов. Назначается даже беременным женщинам и новорожденным детям, пожилым и инвалидам.
  • Допплер УЗИ, в отличие от некоторых других методов диагностики не наносит вред здоровью. Поэтому его можно делать неограниченное количество раз.

Единственным недостатком УЗДГ является относительно высокая стоимость процедуры.

Как делается УЗДГ

Теперь, когда мы выяснили, что такое допплерография и для чего она нужна, можно кратко остановиться на том, как делают УЗДГ.

Никакой особой подготовки к процедуре от пациента не требуется. За несколько часов до обследования нужно перестать курить, ведь никотин влияет на состояние артерий, что может исказить результаты диагностики. Также не нужно принимать горячую ванну, посещать солярий, баню сауну. За сутки до УЗДГ нужно воздержаться от употребления продуктов, напитков, препаратов, которые расширяют или сужают сосуды, разжижают кровь. Например, алкоголь, чай, кофе, энергетики, соленья, аспирин. Все это нужно для того, чтобы врач получил наиболее достоверные сведения о состоянии вашего здоровья.

В назначенное время пациент приходит в кабинет УЗИ и занимает горизонтальное или сидячее положение на кушетке. Врач наносит на обследуемую область тела проводящий гель и при помощи датчика осуществляет диагностику сосудов. Это не больно и занимает 20-60 минут.

Сначала обследование делается в черно-белом В-режиме. Врач видит на мониторе двухмерное изображение сосудов и их аномалий. На этом этапе может быть диагностировано сужение или расширение сосудов, наличие тромбов, бляшек, аневризм. А также проведена оценка степени проходимости артерий и вен, их размеров, диаметра и толщины стенок, локализации.

Далее процедура проводится в режиме УЗДГ. Если делается цветное картирование, на этом этапе специалист видит на мониторе цветное изображение кровотока. При этом цвет венозной крови – синий, а артериальной – красный. Врач оценивает и анализирует характер движения крови в полости артерий и вен, ее консистенцию, степень наполненности сосудов; равномерность, скорость кровотока.

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После этого заполняется протокол обследования. На основании его результатов делаются выводы о наличии, отсутствии или угрозе образования патологии или болезни.

Область применения данного обследования

Типы УЗДГ – что это такое? Это классификация видов допплерографии в зависимости от места расположения обследуемых артерий и вен:

  • Обследование сосудов ног и рук.
  • Диагностика сосудов головного мозга.
  • Исследование магистральных сосудов шеи.
  • Обследование сосудов матки, плаценты и плода при беременности.
  • Диагностика сосудов почек.

УЗДГ сосудов ног – показания

Допплер УЗИ нижних конечностей делается в случае возникновения следующих симптомов:

  • Регулярное онемение и отеки ног.
  • Слабость в ногах.
  • Беспричинные судороги.
  • Боль и/или хромота при физической нагрузке – беге, ходьбе.
  • Снижение местной температуры в конечностях – холодные, бледные ноги.

Симптомы, указывающие на патологию вен нижних конечностей – изменение (потемнение, побурение) цвета конечностей; появление сосудистых звездочек; набухшие и расширенные сосуды, проступающие сквозь кожу; появление повреждений кожи, перетекающих в незаживающие трофические язвы.

УЗДГ сосудов мозга – показания

Обычно, если пациент делает допплерографию сосудов головы, то заодно проводится и исследование артерий, вен шеи. Однако, это зависит от мнения лечащего врача о целесообразности комплексной диагностики, финансовых возможностей пациента.

Сосуды головного мозга исследуют в случае:

  • Регулярных болей и тяжести в голове.
  • Головокружения, обмороков.
  • Шума в ушах.
  • Появления проблем со зрением, не обоснованных возрастом или болезнями глаз.
  • Расстройства координации движения, слабости и «мурашек» в конечностях, нарушения тактильных ощущений.
  • Расстройства сна.
  • Нарушения речи.
  • Ухудшение памяти, способности к концентрации.
  • Травмы головы.

В случае грудных детей показаниями к проведению УЗДГ являются гипоксия, недоношенность и заболевания ЦНС.

УЗДГ сосудов шеи – показания

Данная процедура еще называется доплерография брахиоцефальных сосудов (БЦС) и брахиоцифальных артерий (БЦА).

Показаниями к проведению процедуры являются такие же симптомы, как и при УЗДГ головного мозга.

Дополнительно обследование артерий и вен шеи нужно периодически проходить пациентам из группы риска, то есть тем, у которых диагностированы:

  • Сахарный диабет и /или ожирение.
  • Гипертоническая или ишемическая болезнь, стенокардия.
  • Остеохондроз шейного отдела позвоночника.

Профилактически доплерографию нужно делать также людям старше 40 лет; перенесшим инфаркт или инсульт; а также тем, чьи кровные родственники имеют проблемы с сосудами и артериальным давлением.

УЗДГ при беременности – показания

Допплерография при беременности может проводиться после 21 недели. Она может быть частью планового УЗИ, или назначаться и проводиться целенаправленно.

Показания для проведения УЗДГ внепланово:

  • Заболевания матери – гипертония; сахарный диабет; низкий гемоглобин; токсикоз на поздних сроках; миома матки; инфекции, передающиеся половым путем; болезни почек.
  • Многоплодная беременность или значительное перенашивание.
  • Возраст беременной – до 18, старше 35.
  • Кровянистые выделения.

  • Если в течении предыдущих беременностей были нарушения и патологии.
  • Резус-конфликт.
  • Проблемы с плацентой и плодом – угроза прерывания беременности; патологии, отслоение плаценты; развитие плода не соответствует срокам беременности; обвитие пуповиной, признаки кислородного голодания ребенка.
  • Наличие у матери вредных привычек.
  • Падения, травмы (особенно области живота).

УЗДГ сосудов почек – показания

Врач назначает проведение допплеровского исследования почек в случаях:

  • У пациента диагностирована гипертоническая болезнь и врачи подозревают, что повышение давления связано с патологией почек.
  • Предыдущие исследования показали, что почки имеют разницу в размерах.
  • Симптомы почечной недостаточности.
  • Признаки тромбоза.
  • Травмы тела в области почек.
  • Специалист подозревает, что в почках может нарушиться кровоток.

При обследовании сосудов почек нужна дополнительная минимальная подготовка – за пару дней до процедуры нужно перестать употреблять продукты и напитки, повышающие газообразование.

Таким образом, УЗДГ артерий и вен – это самый современный вид исследования состояния сосудов и характеристик кровотока. Допплерография безопасна, проводится быстро, а результаты можно получить сразу после проведения процедуры. Ее назначают всем категориям граждан без ограничений по возрасту или состоянию здоровья. А главное достоинство этого метода диагностики – специалист может обнаружить доклинические признаки сосудистых заболеваний и предотвратить развитие тяжелых осложнений.

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