Duplex scanning in the diagnosis of vascular pathology

Duplex scanning is a combination of traditional ultrasound (in B-mode) with Doppler techniques for determining blood supply and circulation. This combination is a very effective method of diagnosis in modern angiology.

Duplex scanning in phlebology is considered a "gold standard". In modern cases, modern phlebology uses this technique for diagnosis in almost all cases. Duplex scanning of the veins helps visualize the vasculature, significant in length, recording the movement of blood in it. The use of this method is necessary not only for the diagnosis, but also for the treatment and prognosis of venous pathology.

There are different approaches to the implementation of this procedure. Screening approach allows you to determine only the main issues, a small number of doctors of ultrasound diagnostics without first consulting a given patient with a phlebologist can give a detailed description of the state of veins. A small amount of time is allocated for the examination, approximately 10 minutes. For example, duplex scanning of the veins of the lower limbs (full!) Should take 40-50 minutes. For screening of venous pathology, ultrasound can be used : it allows you to identify bottlenecks, which can then be studied in more detail by duplex scanning.

A more detailed and informative study will be a duplex scan secondary, after a visit to a phlebologist who will identify the necessary questions for resolution and clarification. If this procedure is carried out before his visit, then often there is a need to re-conduct it, since at the reception of the phlebologist there are unsolved questions.

At the reception, the feet are first inspected to identify places that require special attention. Inspection should also be done in the prone position (deep veins are better visible), and in standing position (in this case - superficial). With the help of the sensor, every centimeter of the foot is inspected. There are preclinical stages of diseases, which can only be determined by ultrasound.

The venous pool of the lower limbs includes 26 veins on each side. Often changed are with diseases of the vein of the foot.

As already mentioned, duplex scanning consists of a combination of ultrasonic B-mode and Doppler. In the B-mode, the instrument emits an ultrasound of a certain frequency that penetrates through the tissues. The boundary of tissues of different density causes reflection of ultrasound and its return back to the sensor. This sensor works impulsively. The greater the distance between the sensor and the boundary, the more time will pass from ultrasound radiation to its capture. Thus, the scanning and two-dimensional reconstruction of the vessels under study takes place. The Doppler regime is based on the same effect: ultrasound, when colliding with moving particles, not only reflects, but also changes the frequency, and the change of this parameter is proportional to the speed of the moving object. In the study of the vasculature, the moving objects are red blood cells. At the present stage, it is possible to construct a color flow chartogram in a vessel in which the intensity and direction of blood flow is coded by color. This method is color Doppler mapping.

With the help of these two regimes, one can obtain information on the anatomy of the vessels, the condition of their walls and lumens, assess changes in them themselves, and track changes in hemodynamics. In addition, this method is non-invasive, and also allows to diagnose a significant amount of vascular pathology.