Abstract
1691
Objectives Initial symptom of Raynaud's phenomenon(RP) is color change, such as blanching, cyanosis, and redness reflecting vasoconstriction, hypoxia and reperfusion. After progression, patients complain of abnormal sensation and pain. Usually, Raynaud scan manifests as various perfusion patterns, such as reactive hyperemia or hypoperfusion without normalization. This study is for identifying relavance of perfusion pattern to severity of symptom in Raynaud scan.
Methods 21 clinically suspected RP patient were divided into two group by severity of symptom: 5 patients are in mild group showing only color change and 16 patinets are in severe group showing abnormal sensation or pain. 30mCi of Tc-99m RBC was injected after one hand chilling protocol. Radioactivity from the second to the fifth finger and palm of both hand was recorded. Dynamic acquisition was performed at a rate of frame per 10 seconds until 30 frames and first peak ratio(FPR) was measured. Then, in 10min, 30min, 45min, 60min static image, finger to finger ratio (FFR), palm to palm ratio (PPR) between chilled and ambient hand were measured.
Results In mild group, 5 out of 5 patients showed reacitve hyperemia. In severe group, 5 patients out of 16 patients showed reacitive hyperemia. Although both mild and severe group showed reactive hyperemia, mean FPR in severe group(1.61) is higher than that in mild group(1.43). 5 patients out of 16 patients showed initial hypoperfusion without normalization. 2 patients out of 16 patients showed initial hypoperfusion and delayed hyperemia at 45min. 1 patient with initial hypoperfusion recovered at 30min, but showed delayed hypoperfusion at 45min, 60min static image. In summary, patients having only mild symptom are more likely to show reactive hyperemia. Severe group tend to show wide spectrum of perfusion patterns.
Conclusions Because Raynaud scan manifest as various patterns in relations to severity of symptom, we can predict severity of symptom according to the results of scan. Especially, if perfusion pattern except reactive hyperemia is observed, it suggests that patient has severe symptom.