Session Information
Date: Sunday, November 13, 2016
Session Title: Imaging of Rheumatic Diseases - Poster I: Ultrasound and Emerging Technologies
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Raynaud’s phenomenon (RP) is a clinical disorder that is characterized by paroxysmal vasospasm of small blood vessel after cold exposure or vibration. Radiopharmaceutical perfusion scintigraphy is a noninvasive and quantitative method for evaluation of RP. Interestingly, the increased perfusion or blood pool activity after cold exposure in one-hand chilling protocol has been reported, they are called paradoxical RP. However, little is known about the paradoxical reaction. In this study, we compared radiopharmaceutical perfusion imaging and thermography in patients with RP for the understanding of paradoxical RP.
Methods: Sixty male patients with secondary RP caused by hand arm vibration syndrome were included in this study. Radiopharmaceutical perfusion scintigraphy and thermography were performed for all patients. Blood flow by radiopharmaceutical perfusion scintigraphy in each hand was measured with one hand chilling protocol. According to the chilled finger to ambient finger ratio (CAR), we divided 60 enrolled patients into low and high ratio groups in each hand. The finger to palm ratio in the ambient hand (FPRa) and the finger to palm ratio in the chilled hand (FPRc) were analyzed, and the correlations between blood flow ratios by radiopharmaceutical perfusion scintigraphy and temperature by thermography was evaluated.
Results: Among total 60 patients, the numbers of patients with paradoxical RP, that is classified as high ratio group, were 13 (21.7%) and 12 (20.0%) in left and right hand, respectively, and 6 patients showed paradoxical RP in both hands. FPRa showed positive correlations with baseline temperature (Left, γ = 0.276, p = 0.033; Right, γ = 0.424, p = 0.001, respectively), and CAR showed negative correlations with baseline temperature (Left, γ = -0.291, p = 0.024; Right, γ = -0.273, p = 0.035, respectively). In the high-ratio group, the FPRc values after cold exposure were significantly higher than those of ambient state (Left, 65.8 ± 23.2 vs. 49.2 ± 20.7, p < 0.001; Right, 61.5 ± 16.4 vs. 49.9 ± 9.6, p = 0.013, respectively); while in the low-ratio group, the FPRc values were significantly lower than those of ambient state (Left, 49.9 ± 19.6 vs. 57.0 ± 22.6, p < 0.001; Right, 51.5 ± 24.1 vs. 61.3 ± 21.9, p < 0.001, respectively). In the high-ratio group, baseline temperatures of the left digit were significantly lower than those in the low-ratio group (Left, 25.2 ± 2.9°C vs. 23.1 ± 3.1°C, p = 0.037; Right, 25.2 ± 2.9°C vs. 22.7 ± 3.1°C, p = 0.018, respectively) and baseline temperatures of the right digit tended to be lower than those in the low-ratio group (Left, 25.1 ± 2.9°C vs. 23.5 ± 3.1°C, p = 0.093; Right, 25.1 ± 2.8 vs. 23.3 ± 3.5°C, p = 0.100, respectively).
Conclusion: Paradoxical RP was detected in 20.0 ~ 21.7% of hand perfusion scintigraphy. Low basal blood flow and low baseline temperature of the digit can be related with paradoxical RP in hand perfusion scintigraphy.
To cite this abstract in AMA style:
Choi ST, Seok JW, Lee ES, Song JS, Kwak BK. Low Baseline Temperature and Low Basal Flow Can be Related to the Paradoxical Raynaud’s Phenomenon in Hand Perfusion Scintigraphy [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/low-baseline-temperature-and-low-basal-flow-can-be-related-to-the-paradoxical-raynauds-phenomenon-in-hand-perfusion-scintigraphy/. Accessed June 2, 2020.« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-baseline-temperature-and-low-basal-flow-can-be-related-to-the-paradoxical-raynauds-phenomenon-in-hand-perfusion-scintigraphy/