Contents
The circulatory system of the female body has its own distinctive features, related mainly to the reproductive function. That is why women have a high probability of developing chronic pain syndrome in the pelvic region, as well as the development of vascular venous pathologies of the lower extremities.
In order to diagnose and prevent these diseases in time, there is a modern method of duplex scanning of the vessels of the female small pelvis.
What is this procedure
The female pelvis is fundamentally different from the male pelvis. Its cavity is much wider and has a stronger angle of inclination. This structure greatly affects the vessels. They have significant kinks, and therefore, with excess weight, a long stay in an upright position, and especially during pregnancy, there is a violation of blood flow, which is manifested by severe pain.
The duplex scanning procedure consists in the use of high frequency ultrasonic waves, ranging from two to twenty-nine megahertz.
To conduct such a study, it is enough to have a modern ultrasound diagnostic device equipped with a duplex scanning function.
A distinctive feature of this method is the principle of double visualization of the pelvic vessels.
B-mode allows you to see the structure of soft tissues, their uniformity and density, as well as wall thickness. The result is a two-dimensional black and white image of the organ under study. The density of the fabric is determined by the saturation of the black color.
M-mode displays the processes taking place in real time.
D-mode consists directly in the application of the Doppler effect. It is based on the fact that any moving object emits a certain frequency of sound waves, which changes as it moves. With this procedure, the object of study are erythrocytes – red blood cells. Thus, it turns out that the closer the red blood cell is to the sensor of the device, the higher its frequency becomes.
Registration and fixation by the sensor of such signals reflected from internal structures is the purpose of such a procedure. Then, with the help of a computer program, the received pulses are analyzed, resulting in a two-dimensional image being displayed on the screen.
Varieties of the research method
Dopplerography, or duplex scanning, allows you to visualize those vessels that are located quite deep under the skin layer and internal organs.
There are two options for such a study, depending on the location of the sensor that records the signals:
- transvaginal, in which the sensor is inserted directly into the vagina, and the visualization of vascular blood flow in the pelvis is carried out through the delicate back wall;
- transabdominal, in which the sensor is located in the lower abdomen, generally resembling a conventional ultrasound of the internal organs.
The first method is considered the most informative, since the image obtained in this way is much clearer. It is necessary to know that such a study does not cause absolutely no discomfort. Immediately before the procedure itself, a condom is put on the sensor, which eliminates the possibility of any infection.
The second version of the study is often offered to children or young girls, as well as women who have inflammatory processes in the vagina.
D-mode also provides several options for displaying the flow of blood through the vessels.
The first mode is color, in which the direction of blood flow is characterized by red or blue. The second is energetic, in which the brightness of blood flow, ranging from yellow to saturated red, directly depends on the speed of movement of blood cells.
The method by which a color image is obtained is called Doppler mapping, and the results obtained with its help are cartograms.
Indications for the procedure
Usually, such a procedure is prescribed by a cardiovascular surgeon or a gynecologist, based on the presence of a number of characteristic features:
- Varicose veins. This disease is characterized by impaired venous blood flow caused by loss of vascular elasticity, as well as dysfunction of the valvular apparatus. The result is the appearance of retrograde blood flow, in which fluid accumulates in thin veins, forming varixes – characteristic vascular sacs, similar to grapes, pressing on the internal organs.
- Drawing dull pain in the lower abdomen, largely manifested after a long stay in an upright position. The appearance of such a sign indicates the presence of varicose veins.
- Loss of sensation in the lower extremities, feeling cold in them. Such symptoms are associated with a lack of nutrients and oxygen, which are difficult to transport through severely constricted vessels.
- Burning pain, intermittently occurring when walking, as a result of which it is impossible to cover even short distances without stopping. Often this condition is caused by impaired blood flow in the arteries, which is a consequence of atherosclerosis. With the progression of this disease, lipid metabolism in the body is disturbed, the walls of blood vessels are damaged and atherosclerotic plaques appear.
- Attacks of sharp and acute pain in the lower abdomen, radiating to the thigh. This can be caused by the presence of blood clots in the vessels that clog the lumen of the vessels.
In addition, dopplerography is often used to detect pathological vascular disorders in the ovaries and uterus, myomatous nodes, adhesive and inflammatory processes of the internal genital organs, and various neoplasms in the pelvic cavity. Often this procedure is also carried out during pregnancy in order to detect fetal circulatory disorders, its congenital cardiovascular pathologies or premature placental abruption in time.
Transabdominal examination is contraindicated for open wounds or burns at the site of diagnosis. A transvaginal examination is prohibited in the presence of inflammatory processes in the vagina, during menstruation, and also in late pregnancy, since such an intervention can provoke the onset of labor and lead to premature birth.
Preparation for duplex scanning of pelvic vessels
The presence of gases in the intestines makes it difficult to diagnose, therefore, two to three days before the examination, it is necessary to stop eating foods that increase gas formation: sweets, flour products, potatoes, legumes, cabbage, carbonated drinks.
In addition, you need to know that the study is carried out only with a full bladder. Otherwise, it will interfere with the procedure, as it is located in front of the uterus. For this, it is necessary to drink about two liters of pure water within two hours before the procedure.
Transvaginal diagnosis is carried out exclusively with an empty bladder and on the tenth day from the onset of menstruation. It is also necessary to adhere to the rules of intimate hygiene.
Procedure and possible complications
The procedure is carried out in the ultrasound room of the antenatal clinic or in a hospital setting. It is advisable to conduct this examination on an empty stomach.
With the transabdominal version of the diagnosis, it is necessary to lower the pants or skirt and lie on the couch near the ultrasound machine.
With the transvaginal variant, it is necessary to completely expose the lower part of the body and lie on the couch with the legs bent at the knees and spread apart. Or sit in a gynecological chair.
The sensor is lubricated with a special gel, which contributes to a closer contact of the device with the skin and smooth glide of the meter. When diagnosing, the modes of the device alternately change, assessing the state of blood flow and soft tissues. Sometimes the examination is accompanied by some noise characterizing the sound of blood transporting through the vessels. The duration of this procedure is from ten minutes to half an hour. After the end of the diagnosis, it is necessary to wipe off the remnants of the gel and get dressed. The results of duplex scanning are evaluated and interpreted by a gynecologist. Based on this study, the presence of pathology is determined and the necessary treatment is prescribed.
Conclusions
Duplex scanning of the pelvic vessels is a modern diagnostic method that allows you to identify the presence of vascular pathologies in the female body caused by various disorders of the circulatory system. This is an absolutely safe and painless procedure, which has a fairly short list of contraindications. Such a procedure should be prescribed by a vascular surgeon or a gynecologist, based on the patient’s complaints and the symptoms present. Therefore, before carrying out the procedure, it is necessary to consult with a specialist.