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Duplex scanning of the aortic arch and its branches is a complete ultrasound examination. It is preferred because of the increased accuracy of the results and extended information content. The results allow you to determine the current state of the walls of blood vessels, as well as to detect possible pathologies such as narrowing of the aorta. Based on the analysis obtained, an experienced expert will also be able to draw a general picture of a particular blood flow.
The aorta is considered the central arterial vessel. She received several branches, among which carotid and subclavian solutions are distinguished, which perform the duties of nourishing the brain.
Not only cardiologists or cardiac surgeons can send a patient to such a large-scale clinical trial. Sometimes the appointment is prescribed even by neuropathologists, or narrow specialists from related categories.
Principle of operation
Scanning this part of a large segment of the cardiovascular system is just one of many methods for confirming or refuting a number of ailments. But it is it that is considered one of the most productive, as it is based on a couple of reliable mechanisms for obtaining the necessary information.
The first option provides the basis from the observations of Mr. Doppler, who was an Austrian physicist. In honor of him, the technique was named – dopplerography. The main principle relies on the difference in the received frequency when taking into account the distance from the sensor to the particles. With its help, it is possible to evaluate the elements inside the vessels: erythrocytes, leukocytes, platelets, the liquid plasma part.
By adjusting the frequency of incoming ultrasonic vibrations, the doctor will be able to check not only the presence of blood flow, but also its speed and direction.
The second component of the technique is the so-called “B-mode”. A typical diagnostic of the ultrasonic spectrum is operated by high-frequency pulses. When reflected from the part under study, they are captured by the apparatus.
Based on the results obtained, it is possible to fix possible pathologies that occur in the vascular structure of potentially affected walls. The technology allows you to monitor changes in real time, provided that a two-dimensional image is transmitted.
Together, this guarantees a qualitative and complete assessment of the anatomy of the cardiovascular system and hemodynamics. No other modern methods can provide such accuracy.
Scan classification
Dopplegraphy for the aortic arch provides for two main categories that are similar to each other. This is about:
- mapping;
- energy type.
But the second version is considered more suitable for studying smaller vessels than the aorta, so it is used an order of magnitude less often.
When mapping, the technologies of staining the studied blood flow with two colors are involved. Red is responsible for the indicators of the approach of blood cells to the sensitive sensor. The lighter the shade, the higher the speed of movement of the studied particles. And the blue color indicates the direction coming from the sensor.
When using the ultrasound method, you can also use one of two modes to choose from, based on current suspicions:
- B-mode;
- M-mode.
The first variation involves the continuous production and reception of waves. Due to such a thorough study of the problem area, it turns out to explore the volume on an ongoing basis.
The second approach is intermittent, which works great if you just want to find the affected area.
Indications and contraindications
Since the aorta is the largest vessel of the arterial format, the state of health of the heart muscle will completely depend on its functioning. It originates in the left ventricle. The closer to the base pathology is detected, the stronger the consequences will be.
Usually, cardiologists send for scanning of the aortic arch along with its branches. In their conclusions for issuing a referral, they rely on current analyzes, as well as complaints from the victim. Among them, the most common symptoms are:
- headache;
- noise in ears;
- problems with vision;
- deterioration in coordination.
All of the above are consequences of problems with the activity of the main artery of the body. Thus, a headache is a consequence of a chronic or acute cessation of a stable blood flow to the brain. If the body does not receive enough oxygen, then it will suffer from hypoxia. Outwardly, this manifests itself in tinnitus.
When the cerebral circulation suffers, this guarantees a deviation in the work of the frontal and occipital lobes. They are responsible for vision, which over time can significantly decrease.
Violation of coordination of movements is explained by metabolic disorders. The latter directly depend on the developing ischemia of the cerebellum and the precentral gyrus.
Another striking sign is the weakening of the pulse in the hands. There are many reasons for this, but subclavian artery stenosis is most often to blame. Additionally, this is indicated by freezing of the upper limbs or even their partial numbness.
If the patient has previously passed the initial examination, then the doctor may notice a systolic arterial murmur in the vessels that are separated from the aortic arch. In the presence of a narrowed lumen, the flow acquires characteristic noises.
But most often people come to see a cardiologist for more banal reasons:
- pain syndrome in the region of the heart;
- dyspnea;
- tachycardia.
This may indicate an overload of the aorta or complications in the activity of its valve. To rule out the worst scenarios, the doctor suggests undergoing a duplex analysis.
But even the absence of visible symptoms does not mean that a person is completely healthy. In some cases, experts prefer to be extra vigilant by sending their wards to such a clinical trial. Those at risk are those who:
- are within the retirement age;
- are obese;
- lead a sedentary lifestyle.
Do not exclude from the list of people who are prone to cardiovascular diseases due to heredity. Also, one cannot avoid a profile examination for those who have already confirmed their diagnosis. Patients should be periodically scanned to monitor treatment progress if they have:
- Aneurysm of the aortic arch. The disease involves the expansion of the walls, which first provokes a weakening of their elasticity, and then a sudden rupture.
- Nonspecific aortoarteritis, which has a second name – Takayasu’s disease. Pathology covers the growth of the heart vessel in a granulomatous pattern. After a while, it comes around with a narrowing of the lumen and subsequent violations of the hemodynamic spectrum of action.
- Hypertension. Increased blood pressure several times increases the risk of developing a heart attack or stroke in relation to completely healthy citizens.
- Atherosclerosis. Avoiding complicated medical terminology, the disease is characterized by the formation of intravascular plaques that block the blood flow.
But the list of contraindications for the duplex technique is extremely short. It covers only varieties of shock along with collapse, as well as end-stage oncology. This also included heart and respiratory failure, which are in the phase of decompensation.
Preparatory process
To prepare for the scan, you just need to rule out factors that can blur the clinical picture. These include pharmacological drugs that are designed to help during the course of treatment:
- hypertension;
- heart block;
- angina.
But only the doctor should note the medicine, since sometimes it is easier to shift the procedure for a couple of days than to interrupt a pre-agreed therapeutic program in the middle of treatment.
It is also worth delaying the intake of coffee, which can affect blood pressure indicators.
The procedure begins with the fact that the patient is laid on the couch, placing a roller under the head. Next, the doctor lubricates the sensor with gel, which is designed to improve the conductivity of incoming ultrasonic waves through the subcutaneous fat layer.
The doctor will have to visually assess the area under study in order to correctly distribute the ascending and descending part, as well as the arc and continuations in the thoracic region. The calculation is made on the basis that the arc has received three branches:
- brachiocephalic trunk, located on the right;
- common carotid artery;
- left subclavian artery.
Using the anatomical principle of zone division, the state of the vascular network is assessed using a transducer sensor. To get a clearer picture, the examiner can switch examination modes.
Result interpretation
In the hands of the patient receives the conclusion of an ultrasound scan, with which he again needs to contact the attending specialist. If a person has a rectilinear course of the vascular wall, which has clear edges, then everything is fine. Also, the norm is the constant velocity of laminar blood flow and the absence of display of the vascular lumen. In the output, this will be described in one word: echo-negative.
But sometimes the picture does not look so joyful. Then you can try to deal with suspicions even before going to the profile doctor based on the selected echographic changes.
The following striking manifestations indicate that the victim can be diagnosed with an aortic aneurysm:
- bulge on echography;
- thinned walls;
- increased diameter of the vessel;
- slowing down the blood flow.
If the victim has suspicions regarding the development of thrombosis, then in the conclusion one can find confirmation of fears by mentioning an increased linear velocity of blood flow. A hyperechoic formation, which has an uneven outline, also speaks of an emerging disease.
The following marks will indicate that a person has become a victim of atherosclerosis:
- hyperechoic formation fixed on the vascular wall and having an inhomogeneous density;
- in the center of formation there is a dense structure with minerals – calcification;
- a decrease in the volumetric blood flow velocity with an increase in the linear one.
The diagnostician’s indication of widespread thickening of the vascular wall and turbulent blood flow indicates that the patient has a high probability of Takayasu’s disease.
But even coincidence on all characteristic points does not mean a XNUMX% confirmed diagnosis. The attending physician is also obliged to take into account other test results and complaints of the ward in order to make a final verdict.
Benefits of duplex scanning
Despite the prevalence of the presented technique for examining the aortic arch along with its branches, there are several more ways to identify problems in a given part. Only now, against the background of the modern procedure, the outdated radiological assessment using contrast agents is yesterday.
Angiography provides for a mandatory stage of antiseptic treatment, which is similar to preparation for surgery. And for a non-invasive analogue, it is enough to act with impulses in the examination area without the need to damage it.
The question of safety is in doubt, because ultrasonic waves do not cause any significant harm to the body, it is not in vain that they are used even when examining pregnant women. But the risks of an allergic reaction to the contrast agent injected by the catheter are a serious reason for refusing the procedure. Also, the harm from X-ray radiation does not add joy, which can accumulate and weaken its negative impact after a long time.
Against this background, many doctors prefer to send their wards just to the ultrasound room in order to injure the body less.