Doppler ultrasound or Doppler ultrasound is a research method using ultrasound using the Doppler effect.
In 1842, the Austrian physicist Christian Doppler discovered the famous physical effect, which was later named after him. The effect is universal for any waves (sound, light, radio waves) and allows, by recording changes in the frequency characteristics of the wave, to determine the direction of movement and measure the speed of a moving object.
The Doppler effect is used everywhere today, in astronomy when observing the movement of stars and planets, in radar, by traffic police officers, and it has found a place in medicine.
The Doppler effect in medicine is used to determine the speed and direction of blood movement in the blood vessels and cavities of the heart, as well as the direction and speed of movement of the walls of the heart during its contractions. The effect is used when conducting ultrasound examinations using ultrasonic waves in the diagnostic frequency range.
The use of the Doppler effect in medical ultrasound devices is called ULTRASONIC DOPPLEGRAPHY or USDG.
There are several technologies for applying the effect, these are methods such as color mapping, when the lumen of the vessel is painted in different colors, depending on the properties of the flow, and spectral analysis, when blood flow rates are calculated in different phases of the cardiac cycle, with the calculation of a number of diagnostic coefficients (indices) ).
In modern devices, these technologies are combined, and you can often hear the terms “duplex” or “triplex” Dopplerography of blood vessels, “duplex” or “triplex” scanning.
Indications for ultrasound examination
There are the following types of Dopplerography:
- Dopplerography of the great vessels of the head and neck;
- Doppler ultrasound of the vessels of the lower extremities;
- transcranial Dopplerography of cerebral vessels (duplex scanning);
- Dopplerography of pregnant women.
Duplex scanning is usually combined with Doppler ultrasound of the vessels of the head and neck and is prescribed when the following symptoms occur:
- fast fatiguability;
- frequent dizziness, fainting;
- headaches of various types, migraines;
- sleep disorder;
- noise in ears;
- high blood pressure;
- decreased concentration;
- deterioration of memory, attention;
- suffered a stroke, heart attack.
Indications for ultrasound examination of the vessels of the lower extremities are:
- pain, heaviness, “humming” in the legs;
- expansion of veins and their protrusion;
- cramps (especially at night) in the calf muscles;
- the appearance of non-healing ulcers and wounds on the legs;
- the presence of predisposing factors to atherosclerosis: physical inactivity, diabetes mellitus, smoking, history of vascular diseases, etc.
Dopplerography during pregnancy is aimed at assessing the function of the placenta, uterine arteries, and identifying disturbances in the fetal nutrition and possible pathology in its circulatory system.
What does Doppler ultrasound of blood vessels show? The essence of the method
The technique is based on the Doppler effect - the name given to this phenomenon by the Austrian physicist Christian Doppler. He discovered that when a radiation source moves, its frequency and wavelength change. In the context of ultrasound, this means that the frequency of ultrasound waves changes when reflected from moving red blood cells. Dopplerography allows you to evaluate the speed and direction of blood flow. The sensor sends a series of ultrasound pulses into the tissue, and based on the response, the information is visualized on the screen in the form of a graph. It reflects changes in blood flow velocity at a certain depth.
Doppler ultrasound (USD) can be performed in 3 modes: Today,
duplex ultrasound
, that is, a combination of traditional scanning with Doppler ultrasound.
This allows you to study the vessels anatomically, and the blood flow in them – qualitatively and quantitatively. The combination of duplex diagnostics with color mapping is called triplex scanning
.
Three-dimensional Dopplerography
. It involves the use of computer modeling and the construction of a three-dimensional model of the vessels or entire organs being studied. A three-dimensional image is obtained by scanning an object from different angles. Using Doppler ultrasound, an examination is carried out in real time. This technique does not require invasive intervention, is absolutely safe and has virtually no contraindications. This allows repeated studies to be carried out, if necessary, to the extent necessary to obtain complete and accurate information. Phlebologist surgeon Vladimir Sorokin talks about the essence of the method and its advantages in this video:
What diseases does it detect?
Doppler ultrasound is a highly informative method used to diagnose various vascular pathologies:
- cerebrovascular accidents;
- phlebeurysm;
- vascular malformations;
- deep vein thrombosis;
- hypoplasia of the vertebral arteries;
- atherosclerosis;
- temporal arteritis;
- postthrombotic syndrome;
- vasculitis;
- aneurysms and other vascular pathologies.
The examination allows you to identify the presence of formations that impede or change blood flow (sclerotic plaques, blood clots), check the homogeneity and rhythm of blood flow, assess the compensatory capabilities of blood flow, identify defects in the structure and flow of blood vessels - narrowing, kinks, tortuosity, aneurysms, compression by scars, vertebrae or spasmodic muscles.
Why is it important to conduct an ultrasound examination of the veins in our veins?
In ours, all phlebologists are certified as ultrasound doctors to perform ultrasound scanning of veins, that is, all specialists have undergone multi-level professional retraining and can perform this study. In addition, for many years, working with the most modern ultrasound scanners, the doctors of our center have become experts in the field of diagnosing diseases of the veins of the lower extremities.
Ultrasound duplex scanning of veins is performed by phlebologist, ultrasound doctor Semenov A.Yu.
All this allows us to perform the most complex surgical interventions on the veins of the lower extremities under ultrasound guidance, including endovascular operations (without incisions) and complex reconstructive operations for recurrent varicose veins.
How is it carried out?
Doppler ultrasound is prescribed for suspected vascular pathology. The study is carried out in an office equipped with a modern ultrasound scanner with special sensors. The procedure is completely painless and does not cause discomfort. The doctor applies a special gel to the area of study and uses a sensor to process control points proportional to the projections of the vessel being examined.
The sensor processes the signals and sends them to a computer, which converts them into graphic images and displays them on the monitor. The procedure can last 30-60 minutes, depending on the volume and area of research. The following indicators are assessed:
- wall thickness and diameter of the vessel;
- consistency of vascular valves;
- nature of blood flow;
- resistive and ripple index;
- maximum and minimum speed of blood flow.
15-20 minutes after the ultrasound examination, the patient receives a medical report on a special form. It is also possible to record the result to a flash drive or disk.
What is ultrasonic duplex scanning?
Ultrasound duplex scanning (ultrasound duplex scanning) - this study combines two (duplex) examination modes. The usual (traditional) ultrasound scanning mode, which allows you to see the vein in a two-dimensional black and white image, and the Doppler mode, which allows you to determine the “fluidity” of the blood based on the graph. As a result, the doctor receives complete visualization of the vessel on the screen, which allows one to determine the condition of the vascular wall, the presence of thrombotic masses in the lumen, the operation of the valve apparatus, vessel tortuosity and anomalies, as well as the nature of the blood flow: its speed, turbulence.
Ultrasound duplex scanning of veins is performed by phlebologist, ultrasound doctor I.I. Kalachev.
Technique of the procedure
When a vascular examination is performed, the doctor directs an ultrasonic wave converter to the area of the internal structures of the brain. A powerful ultrasound wave emerges from the conductor and penetrates through the bones of the skull directly to the veins and arteries. When the wave hits an area that requires diagnostics, a reverse display occurs with the visualization of the picture on the monitor, sometimes accompanied by a sound signal. So, in real time, the doctor sees the structure of the vascular system, as well as the blood that moves through the veins.
Diagnosis is carried out in a lying position, and during the procedure it may be necessary to change positions. You must follow your doctor's recommendations. This will help you get more accurate results.
To maximize the passage of the wave through the bone structures, doctors use a special gel; it is applied only to the areas being examined, often the temporal zone, the back of the head and the eye sockets. There is no pain during the procedure.
The duration of the diagnosis is no more than 60 minutes, after which the patient will receive the examination results in electronic or printed form and will be able to go home.
Interpretation of ultrasound examination during pregnancy
If an ultrasound examination is performed by an experienced doctor, he interprets the result on the spot. In other cases, you need to take the results to the treating obstetrician-gynecologist.
Decoding of USGD contains the following characteristics:
Systole-diastolic ratio in blood vessels.
SDO is calculated using the formula. The doctor determines the ratio of the maximum velocity in the vessel in systole and the residual velocity in diastole. The indicator is calculated for large vessels of the uterus, fetus and umbilical cord. The DSO of each vessel varies depending on the period.
Pulsation index
PI in the third trimester should be 0.4 -.64. Ultrasound examination results make it possible to understand:
- whether the fetus suffers from intrauterine hypoxia, and if there is a lack of oxygen, then how dangerous the condition is;
- are there any problems due to a conflict regarding the Rh factor;
- the degree of damage to the vessels of the uterus, placenta and fetus due to diabetes mellitus, cardiac pathology or hypertension of the woman;
- Are there any developmental problems during multiple pregnancies, how are the blood vessels connected and developed in twins.
Rules for preparing for research
On the day of the procedure, you must refrain from:
- Taking antispasmodics such as “Riabal”, “No-shpa”, “Drotaverine”, “Papaverine”, “Baralgin”, “Cinnarizine”.
- Smoking.
- Drinking black tea and drinks containing caffeine.
- Staying in unventilated, stuffy rooms with large crowds of people, which can have a detrimental effect on vascular tone.
If the patient is undergoing treatment with cardiovascular medications, then the advisability of discontinuing them before the procedure must be agreed with a neurologist. In any case, the sonologist must be informed about the treatment being performed before the ultrasound.
Stages of extracranial Dopplerography:
1. In the office, remove all jewelry from your neck and head.
2. Remove clothing from those parts of the body through which the sensor will be passed: neck, collarbones, shoulder blades.
3. Lie on the couch with your head facing the monitor. The doctor will apply acoustic gel to open areas of the body and begin to move the device over them, placing it in areas where medium and large arteries and veins are located. To obtain more accurate data on the state of vascular tone, the patient will need to hold his breath at the doctor’s request, take special medications and change body position.
Doppler ultrasound of vessels located in the cranial area has a different specificity. Acoustic gel is applied to the temples, the back of the head and the area above the eyes. The device is installed there because in these places the bones of the skull are the thinnest and are able to transmit ultrasonic waves.
Norm of SDO in the umbilical cord artery
| Duration, week | The norm of the systole-diastolic ratio in blood vessels |
| 16-19 | 4, 45 — 4,67 |
| 20-22 | 3,75 -3,95 |
| 23-25 | 3,41-3,6 |
| 26-28 | 3,1-3,27 |
| 29-31 | 2,82-2,94 |
| 32-35 | 2,48-2,52 |
| 35-37 | 2,4-2,45 |
| from 38 | 2,19-2,22 |
The norm of SDO in the arteries of the uterus in the third trimester: 1.3-3.7
Cost of ultrasound (USDG, ultrasonography) of the veins of the lower extremities in Moscow
The cost of ultrasound examination of veins in Moscow, as for many high-tech modern services, does not always correlate with quality. You can undergo an examination at a very high cost, but with a fairly low information content. This is possible in some commercial medical centers where there is no modern phlebology. This approach can be called “ultrasound examination for the sake of ultrasound examination.” Things are far from being the best in the public sector. Patients often wait months in line for an ultrasound examination at a public clinic. And very often the results of such diagnostics leave much to be desired. The thing is that in both of these cases, the ultrasound examination is carried out by an ultrasound doctor who does not himself treat venous pathology. The ultrasound examination, which is carried out by the phlebologist himself, is performed in strict accordance with accepted European standards. The results of such an examination may differ radically from those obtained by an ultrasound specialist. The most paradoxical thing in this situation is that ultrasound examination of veins by a phlebologist in Moscow will almost always cost less in relation to commercial medical organizations. At the Moscow Innovative Phlebological Center, we do not logistically separate specialist consultation from ultrasound scanning. An ultrasound of the veins is performed during a consultation with a phlebologist. This is the only way to quickly and accurately obtain comprehensive information about the patient’s venous system.
| Service | Treatment category | Price |
| Appointment with an expert phlebologist with ultrasound scanning of the veins of the lower extremities | 2900₽ 3500₽ | |
| Appointment with an expert phlebologist without ultrasound scanning of the veins of the lower extremities (based on ultrasound results from another clinic) | 2000₽ 2400₽ | |
| Appointment with an expert phlebologist with ultrasound examination based on the results of treatment for one year | for free |
For the convenience of our patients, we work with banks that offer credit lines. Also in our center there is a flexible system of discounts and installments. Payment by Visa and Mastercard is possible. At the end of the course of treatment, the patient is given a package of documents to submit to the tax office for tax deduction.
The price at the Moscow Innovative Phlebological Center for such a specialist consultation with expert-level ultrasound scanning is 2,900 rubles. It should be noted that the price of this examination, which meets the best European standards, has been maintained in our Phlebology Medical Center since 2015.
