Assessment of digital ischaemia and evaluation of response to therapy by 99mTc sestamibi limb scintigraphy after local cooling of the hands in patients with vasospastic Raynaud's syndrome
Küçük Resim Yok
Tarih
2004
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Lippincott Williams & Wilkins
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Aim Cold induced arteriolar constriction in patients with vasospastic Raynaud's syndrome (VRS) produces temporary digital ischaemia. The aim of this study was to ascertain whether Tc-99m sestamibi scintigraphy is useful in the diagnosis and the monitoring of treatment in VRS. Methods Fifteen patients with VRS and 20 matched normal controls underwent examination. Twelve patients with VRS received therapy. For each patient one hand was immersed in iced water for 30s while the other hand served as a control. Ten minutes after cooling, Tc-99m sestamibi was injected and imaging was performed 60 min later. The per cent decrease of the perfusion (%DP) was calculated by semiquantitative analysis to determine the severity of hypoperfusion. Results In all patients with VRS, moderate or marked hypoperfusion were seen in (TC)-T-99m sestamibi images after exposure to the iced water, while there was minimal or mild hypoperfusion in the control groups. Values for %DP were 46.86 +/- 19.04 and 7.85 +/- 4.53 for the VRS group and normal subjects, respectively. The difference between both groups was statistically significant (P = 0.0000). In 12 treated patients with VRS, pre-treatment and post-treatment %DP values were 51.16 +/- 18.42 and 33.58 +/- 17.83, respectively, and a significant difference was seen between both values (P = 0.001). However, there was still a statistically significant difference between control subjects and post-therapy values (7.85 +/- 4.53 vs. 33.58 +/- 17.83, P = 0.0000). The +/- 95% confidence interval of DIP for control subjects was 5.7-10% (chi-squared, P = 0.000). When a DIP of 10% was used as a cut-off point, sensitivity, specificity and diagnostic accuracy were 100%, 70% and 83%, respectively, for the Tc-99m sestamibi scan. There was also a strong correlation between %DP and the duration of the disease (r = 0.80, P = 0.0003). Conclusion The results of this study indicate that a Tc-99m sestamibi scan is a valuable imaging method for the determination of digital ischaemia in vasospastic Raynaud's syndrome, and may play a role in evaluating the response to therapy. (C) 2004 Lippincott Williams Wilkins.
Açıklama
Anahtar Kelimeler
Vasospastic Raynaud's Syndrome, Tc-99m Sestamibi, Scintigraphy, Reflex Sympathetic Dystrophy, Technetium-99m-Sestamibi Scintigraphy, Systemic-Sclerosis, Frostbite Injury, Objective Test, Muscle, Diagnosis, Viability, Flow
Kaynak
Nuclear Medicine Communications
WoS Q Değeri
Q2
Scopus Q Değeri
Cilt
25
Sayı
2
