It would seem that there is nothing easier than to identify varicose veins on the legs. Suffice it once carefully inspect feet and you can see the extended and twisted veins. But that's not enough. A simple inspection can not determine the state of deep vein leg and hip (they just can not see with the naked eye), and that is very important for the correct choice of treatment, the condition of valves, veins and perforating veins.
So, one of the first diagnostic examination of varicose veins is. On examination, the doctor can see the enlarged, twisted veins, blood clots, to assess the state of the color legs, the presence or absence of edema.
In the diagnosis of varicose veins is very important to find out what it varices: a primary or secondary, which develops on the background postthrombophlebitic syndrome. And for this it is important to know the state of the surface terrain, and especially deep venous valve venous state, the state of the perforating veins.
For all this before apply the so-called BCF (bintovye) samples (where they are used now). This is an absolutely safe method of diagnosis, to conduct it only elastic (or even normal) bandage. The essence of these tests is that the doctor puts a bandage on a certain area of foot and controls the nature of filling of varicose veins.
For example, if you put a bandage on the area of the upper thigh, after lifting his leg and then lower it, then we can evaluate the patency of deep veins and perforating veins of the state of valves. If the veins of the imposition of moderately bandage falls off, it means that the deep veins are passable. If varicose veins have been extended, and remain, this means that the deep veins are impassable. The most common reason for this is thrombosis.
When applying the bandage in the upper leg, and at the bottom of the abandonment of "window" assessed the state of valves of perforating veins. If this box "swelled" the veins in this area are insufficient perforating veins with valves.
There are other resin impregnated samples. However, their value in recent years has dropped substantially, as there are other, more accurate methods of diagnosis. In addition, these tests take time.
Ultrasound and Doppler
Today, the main diagnostic method for varicose veins is ultrasound. Ultrasound diagnosis and Doppler allows the physician to the vein "in the slice." A Doppler flow to evaluate the nature, the presence of reverse flow, the consistency of valves of perforating veins, deep vein thrombosis, deep vein patency and the presence of blood clots.
The method of ultrasound - this is the safest and most economical method of diagnosis in the diagnosis of many diseases, including diseases of the veins.
Doppler - a method based on ultrasound, which allows us to estimate the motion of body fluids. Such environments include, above all, the blood in the vessels.
There are several types of Doppler ultrasound:
Color Doppler sonography - a method of diagnosing the nature of the vascular blood flow. Thus, depending on the direction of blood flow, it is painted on the screen in red or blue.
Power Doppler sonography - a diagnosis of vascular blood flow. Depending on the speed of blood flow in the vessel, it is stained bright yellow, with a slower speed is close to the color red. This method of Doppler, roughly speaking, allows you to see if there is blood flow in the vessel. It does not assess the nature of the direction of blood flow. The pulsed-wave Doppler - a method of study which allows us to estimate the rate of blood flow in vessels.
Duplex Doppler ultrasonography - a method in which the two methods simultaneously Doppler: B-mode and color Doppler sonography.
Triplex Doppler sonography - a method that uses three Doppler methods simultaneously: B-mode, color Doppler and pulsed-wave Doppler.
Ultrasonic method of diagnosis - the most important method of diagnosis of varicose veins. Its advantage is that it is noninvasive, ie, its holding does not require any intervention - either needle insertion or injection of certain drugs.
With ultrasound the doctor reveals the presence perfonatnyh veins and notes of these markers. This is done to make it easier for the surgeon to search for these veins, which are needed to tie in the treatment of secondary varicose veins (r. Is, postthrombophlebitic syndrome).
Angiography - an x-ray is a diagnostic method of blood vessels. It consists in introducing into the vessel a special solution - X-ray solution, after which the radiograph. Thus, allowing the physician to see angigrafiya condition of vessels, their course, the diameter of the lumen, the presence of blood clots.
Angiography is called venous phlebography. When venography radiopaque dye is injected into a vein to the patient. To date, the value of phlebography has declined due to the fact that there were modern ultrasonic diagnostic methods.
In addition, the method is not without venography and special disadvantages, among which the most important - an introduction to the patient's blood allergenic substances. Therefore, prior to venography performed allergy test to determine the sensitivity of the patient for this contrast agent.
The method of venography is currently used only for special indications, when Doppler diagnostic methods do not allow us to determine some ososbennosti venous leg.
Other methods for diagnosis of diseases of veins, such as plethysmography, flebomanometriya, flebostsintigrafiya, three-dimensional computed tomography, etc. used much less frequently, mainly in the case of diagnosis of certain complications of varicose veins and lack of informativeness of ultrasonic methods.