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Ultrasound of the arteries of the internal organs of the abdominal cavity
Medical expert of the article
Last reviewed: 06.07.2025
Where to get an ultrasound of blood vessels, how the diagnostics are performed and what is special about the study, let's consider these questions.
The arteries of the abdominal viscera should be examined on an empty stomach. Scanning with full expiration gives a better picture than with full inspiration. The results are documented by spectral traces, and the measured blood flow velocities are interpreted according to the blood flow in the aorta. Direct scanning in color mode sometimes facilitates the visualization of small vessels, but delays real-time visualization, and circular movements of the transducer in search of vessels can increase the number of color artifacts.
The main indications for ultrasound examination of blood vessels:
- Detection of chronic venous congestion and varicose veins.
- Diagnostics of organs and systems of the body.
- Monitoring and prevention of vascular diseases.
- Diagnosis of heaviness in the limbs and the appearance of spider veins on the skin.
The ultrasound scanning procedure is safe and painless for the patient. With the help of ultrasound waves, it is possible to determine the features of the systemic blood flow to different organs. Special attention is required for the diagnosis of the brain vessels, since a violation of the blood supply leads to dizziness, high blood pressure and noise in the head. The second most important is the ultrasound of the vessels of the neck and cervical vertebrae. Vascular insufficiency in this area can lead to epileptic seizures and atherosclerosis.
Normal ultrasound image of arteries of internal organs
When performing ultrasound examination of the abdominal arteries, a combination of blue and red segments is seen, the nature of which depends on the direction of blood flow (towards or away from the transducer). Increased velocities may be noted in areas such as the origin of the superior mesenteric artery, where blood flows directly towards the transducer, causing colors to become brighter or even smeared. Since the origin of the superior mesenteric artery is a common area for increased blood flow due to stenosis, careful analysis of the velocity spectrum is necessary to distinguish artifacts from true stenosis.
A 5 MHz transducer is used for examination of patients with asthenic physique. The higher spatial resolution and expanded ultrasound beam control capabilities of linear transducers facilitate visualization of structures such as the origin of the inferior mesenteric artery.
Blood flow in the arteries of the abdominal viscera depends on food intake and respiratory movements. When examined after a meal, peak systolic blood flow velocity and end diastolic blood flow increase, although these effects are less pronounced in the celiac trunk than, for example, in the superior mesenteric artery. The spectrum from the superior mesenteric artery on an empty stomach often has a three-phase pattern, and after a meal it becomes two-phase. The absence of changes in the spectrum after a test meal has diagnostic value.
Ultrasound signs of pathology of arteries of internal organs
Intestinal ischemia
Chronic intestinal ischemia may be asymptomatic for many years due to the development of collaterals. However, acute ischemia may develop when thrombi form on atherosclerotic plaques or in the case of embolism. Of the mesenteric vessels, the superior mesenteric artery is most often affected due to its localization.
Differential diagnosis includes non-occlusive intestinal ischemia caused by postoperative or pharmacological vasospasm, which is visible on ultrasound. Ultrasound does not allow to exclude acute occlusion of mesenteric vessels, since it often visualizes only the sites of origin of the arteries, especially if there is flatulence and pain. If ultrasound of the superior mesenteric artery reveals a sudden interruption of blood flow in the absence of spectral traces, then in the presence of the corresponding clinical picture and laboratory data (increased lactate levels in the blood plasma), a diagnosis of occlusion should be made
Doppler ultrasound helps to detect chronic intestinal ischemia. The proximal superior mesenteric artery is a site prone to stenosis and is easily examined with Doppler ultrasound. Systolic and diastolic velocities are important parameters for quantifying stenosis.
Collaterals are often found, but digital subtraction angiography is required for accurate mapping of the circulation. The occluded superior mesenteric artery is identified by bright retrograde flow through the Buhler anastomosis.
[ Arcuate ligament compression syndrome
Patients (usually young women) present non-specific abdominal complaints that usually resolve on their own. This is caused by proximal compression of the celiac trunk by the diaphragmatic crura during full exhalation.
Aneurysms
Aneurysms of the arteries of the abdominal internal organs are rare and are usually discovered by chance. The splenic and hepatic arteries are most often affected. Pseudoaneurysms can develop in these vessels due to tumor erosion, inflammatory processes, and other reasons.
Vascular prostheses
Vascular prostheses have echogenic borders, visible in this case due to the application of the prosthesis to the area of occlusion of the celiac trunk. Doppler ultrasound is a non-invasive method for detecting postoperative complications such as suture aneurysm, anastomotic leakage and occlusion.