How is ultrasound testing used to diagnose and treat vein problems?

BY DR. COHEN

The ultrasound is the most important diagnostic tool vein doctors have.

As you may know, ultrasound machines work by generating harmless, painless, inaudible sound waves and emitting them into the body through an instrument placed on the skin (with gel in between). The sound waves reflected back are then detected. The location, delay and quality of the reflected sound waves are converted to an image on a monitor, which shows the structures in or under the skin.

To measure the actual blood flow inside the veins ultrasound machines also can do Doppler testing. You know how the sound of a train whistle or siren changes pitch as it passes you? That’s the Doppler effect, which is the change in a sound wave’s frequency after reflecting off a moving object. In our case, the sound waves reflect off of the blood cells. Doppler lets us measure the direction and velocity of blood flow.

When the Doppler information is visually layered on top of the ultrasound image, we have what we call “Duplex Ultrasound” which shows us the vein structures as well as the direction and flow of blood. This is the key to vein diagnosis.

The vast majority of leg vein ultrasound tests are done to detect dangerous blood clots in the veins. These tests are generally done with the patient lying down as the technologist or physician compresses the vein while watching the ultrasound image. Normal veins will compress while veins with clots will not.

Often, new patients come to us saying that they’ve already had normal ultrasound tests. But if those tests were for blood clots, they probably won’t detect the leaky valve problems that can show up as varicose veins. That’s why I always ask if the ultrasound was done lying down or standing up. It tells me whether or not they looked at valve function.

So how do we do it? When we do the test standing up, gravity naturally pulls the blood in your legs down. If your vein valves are normal, when we squeeze the calf, the blood will be pushed up by the squeeze and then, when released, the Doppler will detect no backflow because the one-way valves worked. If your valves are leaking, when the calf-squeeze is released, the Doppler will show a reverse blood flow (reflux) back down the vein.

Ultrasound imaging also has other important uses in vein treatment. When laser or RF ablations are performed, we use ultrasound to guide the procedure by showing the doctor exactly where to insert and position the fibers and where to inject the local anesthetic. When we perform sclerotherapy injections, we often use ultrasound to help us guide the needle into the vein and confirm effectiveness. That’s called “ultrasound-guided sclerotherapy” — as you might have guessed.

Finally, we use ultrasound to evaluate the effectiveness of prior treatments. It can tell us if there are any complications, or any additional veins needing treatments.

If you have vein problems, whether you’ve already had an ultrasound or not, you can arrange for a quick and easy consultation right now by calling 201-265-5300.

About us: There are 20 million Americans with vein problems that can seriously affect the quality of their lives. And as we age, they just get worse. As one of the few New Jersey medical practices committed exclusively to vein care, Advanced Vascular Vein Care is uniquely capable of alleviating those problems, whether they are medical or cosmetic. All treatments are non-surgical, usually covered by insurance, and delivered in an office setting. And we do it as it should be done – with compassion, excellence, affordability, convenience, and the personal touch. Call 201-265-5300 or visit AdvancedVascular.com for a quick and easy consultation.