Medical research and diagnostics

Duplex scanning of vessels of the pelvic vessels in women

The circulatory system of the female body has its own distinctive features, related mainly to reproductive function. That is why women are highly likely to experience chronic pelvic pain syndrome, 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 vessels of the female small pelvis.

What is this procedure

The female pelvis is fundamentally different in structure from the male. Its cavity is much wider and stronger than the angle of inclination. This structure largely affects the vessels. They have significant excesses, and therefore with excess weight, a long stay in an upright position, and especially during pregnancy, there is a violation of blood flow, manifested by severe pain.

The duplex scanning procedure involves the use of high-frequency ultrasonic waves oscillating in the range from two to twenty-nine megahertz.

To conduct such a study, it is enough to have a modern ultrasound diagnostic apparatus equipped with a duplex scanning function.

A distinctive feature of this method is the principle of dual visualization of the vessels of the pelvis.

B-mode allows you to see the structure of soft tissues, their uniformity and density, as well as the wall thickness. The result is a two-dimensional black and white image of the organ under investigation. The density of the fabric is determined by the saturation of black.

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, changing as it moves. With this procedure, the object of study is red blood cells - red blood cells. Thus, it turns out that the closer the red blood cell to the device’s sensor, the higher its frequency becomes.

Registration and fixing by the sensor of such signals reflected from internal structures is the goal of such a procedure. Then, using a computer program, the received pulses are analyzed, the result of which is a two-dimensional image displayed on the screen.

Varieties of 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 vascular blood flow is visualized in the pelvis through the delicate posterior wall;
  • transabdominal, in which the sensor is located in the lower abdomen, generally resembling a conventional ultrasound of internal organs.

The first method is considered the most informative, since the image obtained in this way is much clearer. In this case, you must know that such a study does not cause absolutely any discomfort. Just before the procedure, a condom is put on the sensor, which eliminates the possibility of any infection.

The second research option 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 blood flow through the vessels.

The first mode is color, in which the direction of blood movement is characterized by red or blue. The second is energetic, in which the brightness of the blood flow, from yellow to rich 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 called cartograms.

Indications for the procedure

Typically, such a procedure is prescribed by a cardiovascular surgeon or gynecologist, based on the presence of a number of characteristic signs:

  1. Varicose veins. This disease is characterized by a violation of venous blood flow caused by a loss of vascular elasticity, as well as valve dysfunction. The result is the appearance of retrograde blood flow, in which fluid accumulates in the thin veins, forming varixes - characteristic vascular sacs that look like grape clusters that press on the internal organs.
  2. Drawing dull pain in the lower abdomen, manifested to a large extent after a long stay in an upright position. The appearance of such a sign indicates the presence of varicose veins.
  3. Loss of sensitivity of the lower extremities, a feeling of cold in them. Such symptoms are associated with a lack of nutrients and oxygen, which are difficult to transport through highly narrowed vessels.
  4. Burning pain that periodically occurs when walking, as a result of which it is impossible to overcome even small distances without stopping. Often this condition is caused by a violation of blood flow in the arteries, which is a consequence of atherosclerosis. With the progression of this disease, lipid metabolism in the body is disrupted, the walls of the vessels are damaged and atherosclerotic plaques appear.
  5. Attacks of sharp and acute pain in the lower abdomen, extending to the thigh. This can be caused by the presence of blood clots in the vessels, which clog the lumen of the vessels.

In addition, dopplerography is often used to detect pathological vascular disorders in the ovaries and uterus, myomatous nodes, adhesions 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 violations of the blood supply to the fetus, its congenital cardiovascular pathologies or premature detachment of the placenta.

A transabdominal examination is contraindicated in open wounds or burns at the diagnosis site. A transvaginal study is forbidden to do 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 the vessels of the pelvis

The presence of gases in the intestines significantly complicates the diagnosis, therefore, two to three days before the examination, it is necessary to refuse to eat 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 clean water for two hours before the procedure.

Transvaginal diagnosis is performed exclusively on the empty bladder and on the tenth day from the onset of menstruation. It is also necessary to adhere to the rules of intimate hygiene.

The procedure and possible complications

The procedure is carried out in the ultrasound room of a antenatal clinic or in a hospital. It is advisable to conduct this examination on an empty stomach.

With the transabdominal diagnostic option, it is necessary to lower the pants or skirt and lie on the couch near the ultrasound machine.

In the transvaginal variant, it is necessary to completely expose the lower body and lie on the couch with legs bent at the knees and spread apart. Or sit in the gynecological chair.

The sensor is lubricated with a special gel, which contributes to a more tight contact of the device with the skin and smooth sliding of the meter. During diagnosis, the modes of the apparatus alternately change, assessing the state of blood flow and soft tissues. Sometimes the examination is accompanied by some noise characterizing the sound of transporting blood through the vessels. The duration of such a procedure is from ten minutes to half an hour. After the diagnosis is complete, it is necessary to wipe off the remnants of the gel and get dressed. The results of duplex scanning are evaluated and decoded by a gynecologist. Based on this study, the presence of pathology is determined and the necessary treatment is prescribed.


Duplex scanning of the vessels of the pelvis is a modern diagnostic method that allows you to detect 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 with 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.

Watch the video: Dr. David Greuner explains pelvic vein congestion, pelvic pain and treatment (January 2020).