Veins of the upper extremities ultrasound anatomy. Duplex scanning of arteries and veins of the upper extremities. Indications for ultrasound examination of the arteries of the upper extremities
Vascular duplex scanning (USDS) is an ultrasound diagnostic method that combines Doppler examination with traditional ultrasound. It is used to study the pathology of blood vessels - veins and arteries. It allows the specialist to see the structure of vessels of various locations and the movement of blood through them.
A standard ultrasound scan provides a two-dimensional image (structure and developmental anomalies) of the vein. The Doppler mode reveals the direction of blood flow and the speed of its movement. An even more advanced method is triplex scanning. It combines B-mode, color Doppler mapping and spectral Doppler analysis.
In modern medical institutions, the patient can undergo duplex scanning of the vessels of the upper and lower extremities, as well as Doppler ultrasound of the vessels of the head and neck. Duplex scanning of the veins of the upper extremities is performed less frequently than that of the lower extremities, but it makes it possible to detect vascular diseases in the early stages, even with a mild clinical picture or complete absence of symptoms.
Indications and contraindications
It is recommended to undergo an ultrasound scan of the arteries and veins of the upper extremities in the following cases:
- Swelling of the hands with redness of the skin and severe pain. Although stable edema, as an independent symptom, with normal functioning of the kidneys and heart can be a reason for duplex scanning.
- Numbness of the upper extremities, periodic tingling, goosebumps and other uncomfortable sensations.
- Difficulty in moving your arms and developing weakness in them.
- Frequent involuntary muscle contractions as a result of overexertion.
- Paleness of the fingers with periodic pain.
- Serious injuries to the upper extremities, which entail damage to vascular bundles.
- After vascular surgery.
- With a congenital anomaly of vein development.
Such examination should be performed for preventive purposes by people at particular risk. As a rule, they have the following pathologies: endocrine diseases, blood diseases, autonomic dysfunction, chronic venous diseases, hereditary predisposition to vascular pathologies.
Duplex scanning of the veins of the upper extremities has no absolute contraindications for its implementation. Relative ones include significant damage to the skin of the upper extremities, which can make it difficult to apply the ultrasound sensor to the skin.
Ultrasound scanning of the vessels of the upper extremities can be performed as often as necessary to make the correct diagnosis and carry out adequate therapy. There are no negative consequences for the patient’s body from the frequency of such examination.
Even if a blood flow problem is suspected in only one arm, both limbs are still checked for comparison.
Performing diagnostics
No special preparatory period is required for ultrasound scanning of the veins of the upper extremities. Immediately before the examination in the ultrasound diagnostic room, the patient is asked to free his hands from clothing (sometimes it is appropriate to undress to the waist) and remove jewelry and other items that may interfere with the examination.
In the ultrasound diagnostic room, the process will occur as follows:
- The examination is carried out in a supine or sitting position. In some cases, it is advisable to measure blood pressure during the study, so a tonometer cuff is placed on one or both arms of the patient.
- The ultrasound doctor lubricates the high-frequency sensor with conductive gel and begins to move it along the arm in the area of the venous projection.
- By changing the position of the ultrasound sensor, the specialist assesses the condition of the vessel wall and measures blood movement indicators.
- During the diagnostic process, the doctor may squeeze the patient's shoulder or forearm to speed up the movement of blood through the veins, thereby assessing cardiac blood flow.
- The resulting image is instantly processed and displayed on the monitor screen.
- In some cases, it is enough to examine one limb, but in some patients 2 arms are examined at once.
Duplex scanning of the veins of the upper extremities continues for 30-40 minutes. After the examination is completed, the patient can be freed immediately. There are no subsequent restrictions. This medical procedure is absolutely safe for the patient; it does not involve any complications or side effects.
During the diagnostic process, the patient does not experience pain or serious discomfort. He may feel a slight cooling sensation from the ultrasound gel when applied to his skin. But this can be avoided if you first warm the gel to body temperature. And also if blood pressure is measured during the examination, the tonometer cuff will be inflated and the patient will feel tension in this area.
Duplex (triplex) scanning is considered the standard in vascular research and to some extent can replace angiography, which requires the administration of contrast and exposes the patient to radiation.
Varicose veins on the hands are unlikely, but the possibility exists
Decoding the results
As a result of examining the veins of the arms, the protocol contains few digital indicators, but includes the following parameters:
- anatomical structure;
- patency of venous vessels;
- the speed of blood flow through them;
- the presence of abnormal formations in the lumen of the vessel.
Normal ultrasound performance indicators in conclusion are indicated as follows. There are no obstructions to blood flow in the veins examined. The veins are of normal location and are not enlarged in size. No blood clots were detected in the examined vessels.
If pathology is present, then during ultrasound scanning an asymmetry of blood flow between opposite parts of the patient’s body is detected. If the blood flow is blocked in any area, then during listening in this place a high-pitched and sharp sound will appear. In this case, the blood will move at a reduced speed. The detected obstacle may be a blood clot, partial or complete narrowing of the lumen of the vessel, or an aneurysm.
Duplex scanning of the hands allows the specialist not only to detect blood clots and dissections in the vessels of the upper extremities, but also to easily determine their location, size and structure. Ultrasound scanning allows examination from the standpoint of quantitative and qualitative parameters of blood flow, which ultimately helps the phlebologist determine further treatment tactics.
Disruption of the veins and arteries of the arms is best assessed comprehensively in interaction. For this purpose, a comprehensive ultrasound of the veins and arteries of the upper extremities is performed.
The technique makes it possible to reliably and quickly assess the condition of the main veins and arteries, as well as identify pathological venous refluxes (places of blood flow from deep to superficial veins).
A comprehensive ultrasound of the veins and arteries of the upper extremities is also aimed at determining the condition of the venous valves and measuring the characteristics of blood flow.
Doppler ultrasound (USDG) of the arteries of the upper extremities includes registration and assessment of arterial blood flow in the vessels in real time.
Doppler ultrasound of the arteries of the extremities allows for quantitative measurement of blood circulation indicators in case of suspicion:
on wall-occlusive processes in arteries,
aneurysms,
arterial anomalies, vasculitis;
decreased peripheral pulsation;
to predict conservative or surgical tactics and determine surgical risks.
A comprehensive ultrasound of the veins and arteries of the upper extremities also records:
thickening or narrowing of the vascular wall, its integrity is determined;
narrowing of the lumen of the vessel itself;
the presence of blood clots and sclerotic plaques - the main causes of vasoconstriction;
presence or absence of tumor formations;
blood flow indicators;
vessel deformations, curvature having hereditary causes;
inflammatory process.
Our advantages:
No special preparation is required for the procedure.
The MEDOC network of antenatal clinics provides its patients with high quality medical services. This applies primarily to diagnostic studies.
Our advantages:
modern equipment that meets international standards;
qualified specialists with extensive experience;
convenient work schedule: clinics are open from 7 to 21 on weekdays and from 8 to 20 on weekends;
the doctor will spend as much time with you as you need
Disorders of the functioning of the veins and arteries of the upper extremities are much less common than similar pathologies of the lower extremities, and, nevertheless, they pose a threat to the patient’s health and significantly reduce the quality of life.
Disturbances in the blood flow of the veins and arteries of the hands lead to unpleasant manifestations and consequences. Therefore, therapy for disorders should begin when the first clinical manifestations occur.
Ultrasound of the veins and arteries of the upper extremities provides a unique opportunity for a safe, painless and accurate study of pathologies of the blood vessels of the hands.
When does a doctor prescribe a comprehensive examination of the veins and arteries of the upper extremities?
Ultrasound is performed in the following situations:
with swelling of the hands, feeling of numbness;
for pain in the hands
with frequent cramps, especially at night;
with cold hands;
with arterial and venous insufficiency;
with diabetes mellitus;
when trophic ulcers appear.
In addition, indications for ultrasound may include traumatic injuries to the blood vessels of the hands due to fractures, bruises, and muscle tears. It is urgent to undergo an examination at the first signs of an aneurysm.
What indicators are recorded on ultrasound of the arteries and veins of the upper extremities? What are the main dysfunctions of the arteries and veins shown by ultrasound?
Typically, an ultrasound of the hands examines: The walls of arteries and veins, their structure. First of all, this is to determine the presence of thickenings or narrowings of the vascular wall. The walls of the vessel are also checked for integrity.
The lumen of the blood vessels itself. First of all, the narrowing of the lumen is alarming.
The cause of the narrowing of the vessel is recognized. Most often, narrowing of the lumen occurs due to atherosclerotic plaques that settle and become attached to the walls. Blood vessels also narrow as a result of blood clots. Sometimes the lumen decreases due to pressure created by tumors of surrounding tissues or enlarged lymph nodes.
The exact location of the cause that caused the narrowing is recorded. Its character is determined.
The speed of blood flow in the vessel. Its main indicators.
Various vessel deformations, curvature and tortuosity, including changes caused by heredity.
Thrombosis and accompanying inflammation are diagnosed.
How is the research going? Is special training needed?
No special preparation is needed.
The study takes on average half an hour. The patient usually lies on a couch. The doctor holds the ultrasound probe, pressing it against the control points of the vessels, and examines graphic images of sections of arteries and veins on the monitor.
During the examination, to ensure that the sensor fits tightly to the patient’s body, the doctor applies a special gel.
Ultrasound of the arteries and veins of the upper extremities is safe and painless.
Diseases of the circulatory system of the upper extremities often manifest obvious signs only at the progression stage. But the consequences of their development, even at the initial stage, can be dangerous for the entire organism.
For the purpose of timely diagnosis of such pathologies, ultrasound of the arteries of the upper extremities is used on modern equipment.
The essence of the method of ultrasound diagnostics of blood vessels of the hands
It is not possible to detect morphological changes, obstruction, the presence of atherosclerotic plaques in the arteries and veins of the arms visually through a clinical examination - the skin and muscle tissue hide the circulatory system.
At the same time, ultrasound examination makes it possible to detect pathological processes even in deep-lying vessels.
Ultrasound in the form of a high-frequency pulse, directed deep into the body of the upper limb, collides with blood vessels, pulsating blood and returns back, generating a corresponding signal in a graphic format. The display of the ultrasound machine displays anatomical and physiological disorders of veins and arteries, compactions, dilations and other pathological changes.
Subject of ultrasound diagnostics of arteries of the upper extremities
Ultrasound scanning of the peripheral circulatory system allows the doctor to detect hidden symptoms indicating the onset of the disease.
Also, ultrasound of the arteries of the arms allows you to monitor the dynamics of disease progression and monitor the effectiveness of prescribed therapy.
The main results of ultrasound diagnostics are:
- assessment of the thickness of vascular walls;
- identification of pathological formations - blood clots, plaques;
- detection of anatomical abnormalities of the arteries of the arms;
- assessment of the state of the lumen of blood vessels of the upper extremities.
During the ultrasound examination, foci of the inflammatory process are detected in the area where the arteries of the upper extremities are located, the consequences of traumatic injuries, tumors, and enlarged lymph nodes.
At the same time, deformations of the vascular bed, violations of the integrity of the arteries of the arms and other pathological phenomena become obvious.
Indications for ultrasound examination of the arteries of the upper extremities
A referral for ultrasound diagnostics is issued by the attending physician. The reasons for undergoing an ultrasound scan may be the results of a clinical examination, suspicion of diseases of the endocrine system, or the presence of mild symptoms in order to confirm or refute the primary diagnosis.
Indications for undergoing ultrasound examination of the blood vessels of the hands are:
- frequent cases of numbness of the upper extremities;
- venous and arterial insufficiency;
- symptoms of diabetes;
- progression of vasculitis;
- convulsive phenomena and pain in the hands;
- the occurrence of trophic ulcers.
The reason to do an ultrasound of the arteries in the arms is the patient’s complaint of a feeling of coldness, trembling, and weakness of the upper extremities.
What complaints do patients referred for ultrasound of the vessels of the upper extremities present?
- weak pulse;
- difference in blood pressure in the arms;
- pain when abducting and raising the arms;
- pain during exercise;
- numbness, chilliness;
- decreased muscle strength;
- a feeling of rapid fatigue in the muscles of the forearm and fingers;
- injuries, trophic changes;
- loss of the ability to perform fine movements with the fingers.
Conditions for undergoing ultrasound examination of hands
During the study, it is possible to establish the following pathological abnormalities: inflammation of the arteries; atherosclerosis of the vessels of the upper extremities; the formation of thrombosis or thrombophlebitis. At the same time, during ultrasound of the arteries of the upper extremities, it is possible to assess blood flow, its intensity and peripheral resistance.
To undergo this procedure, no prior preparation or adherence to dietary recommendations is required. The ultrasound diagnostic process takes up to 15-20 minutes, the result is given immediately.
- inflammation of the arteries;
- atherosclerosis of the vessels of the upper extremities;
- the fact of the formation of thrombosis or thrombophlebitis.
At the same time, during ultrasound of the arteries of the upper extremities, it is possible to assess blood flow, its intensity and peripheral resistance.
Using ultrasound of the vessels of the upper extremities you can:
- quantify blood flow in arteries and veins;
- identify vascular disorders, including those caused by blood clots and atherosclerotic plaques;
- determine the presence of stenosis (narrowing) of the arteries, as well as their significance;
- determine the presence of a blood clot, as well as measure its size and evaluate its structure;
- assess blood flow to organs and tissues;
- diagnose the presence of aneurysms.
The study of the vessels of the upper extremities using ultrasound is based on the Doppler effect, which is why the diagnostic method is called Doppler ultrasound (USD) of the vessels of the upper extremities.
How an image is obtained with an ultrasound scan: special ultrasonic sensors emit waves, when they follow a blood vessel, they can be visually distinguished from blood cells. The ultrasound device perceives the reflected waves, after they are converted into electrical impulses, immediately after this, in real time on the monitor you can see graphs and photos in color, which show the flow of blood through the blood vessels.
Dopplerography provides the opportunity to study just one function - whether there is a disorder of patency in the vessels. In addition, in a medical institution you can undergo duplex scanning of blood vessels (USDS), which allows you to study two functions: anatomical diagnosis of blood vessels and assessment of the speed of blood flow. The most extensive study - triplex scanning includes: studying the structure of blood vessels, assessing blood flow and vascular patency. Research results are available in color images.
Doppler ultrasound allows you to:
- Assess venous and arterial blood flow;
- Diagnose vascular disorders, including consequences after the formation of blood clots and atherosclerotic plaques;
- Identify narrowing in the arteries and its level;
- Identify a blood clot, determine its size and structural features;
- Assess the level of blood supply to organs and tissues;
- Diagnose protrusion of the arterial wall (in the presence of aneurysm pathology).
Without ultrasound, it is impossible to perform surgical intervention on blood vessels. It is this study that can identify the factors that precede impaired circulation.
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