technetium-tc-99m-medronate and Raynaud-Disease

The aim of this study was to compare the diagnostic performances of two hand perfusion scintigraphy protocols for diagnosing Raynaud's phenomenon (RP).. We enrolled 130 patients who underwent hand perfusion scintigraphy for suspected RP and 40 normal controls. Of these, 66 patients (group A) and 25 normal controls underwent 99mTc-methylene diphosphonate hand perfusion scintigraphy without one-hand chilling, and the finger-to-palm ratio (FPR) was calculated. The remaining 64 patients (group B) and 15 normal controls underwent 99mTc-methylene diphosphonate hand perfusion scintigraphy with one-hand chilling, and three parameters (the chilled-to-ambient hand ratios of the first peak height, initial slope, and blood pool uptake) were calculated.. Forty-eight and 47 patients were clinically diagnosed with RP in groups A and B, respectively. In group A, patients with RP had significantly lower FPRs compared with those without RP, and the receiver operating characteristic curve analysis showed that an FPR of 0.51 was the best cutoff value for diagnosing RP, with a sensitivity of 63% and a specificity of 83%. In group B, the three aforementioned parameters differed significantly (lower or higher) between patients with and without RP. The receiver operating characteristic curve analysis provided highly sensitive and specific results for all three parameters. The initial slope ratio showed the highest sensitivity of 87% and a specificity of 88% when using cutoff values of 0.78 and 1.25.. Although both protocols for hand perfusion scintigraphy showed high specificity for diagnosing RP, the protocol with one-hand chilling showed higher diagnostic ability compared with that without one-hand chilling.

Topics: Adult; Case-Control Studies; Cold Temperature; Gated Blood-Pool Imaging; Hand; Humans; Middle Aged; Perfusion Imaging; Raynaud Disease; ROC Curve; Technetium Tc 99m Medronate

We introduce the use of (99m)Tc-hydroxymethylene diphosphonate (HDP) digital blood flow scintigraphy to diagnose Raynaud's phenomenon (RP).. Fifty-seven patients with RP and 60 healthy controls were recruited. One hand was chilled by immersion into water at 4 degrees C, and then an intravenous bolus of 740 MBq of (99m)Tc-HDP was injected. The radioactivity from the second to the fifth fingers of both hands was recorded. Acquisition was performed at a rate of one frame per 2 seconds until 155 frames. We calculated 4 ratios by comparing the activity curves of the chilled hand with those of the ambient hand.. The chilled to ambient hand ratio of the initial slope was significantly lower in the patients with RP (0.28 +/- 0.18) than in the controls (0.78 +/- 0.20) (p < 0.001). The chilled to ambient hand ratio of the first peak height, 30-second area under the curve, and blood pool uptake were also lower in the patients with RP than in controls (p < 0.001 for each). The initial slope ratio of 0.51, used as a cutoff value, showed a sensitivity of 91.2% and specificity of 93.3%. The loss of the initial spike curve, the presence of a slowly progressing radioactivity curve, and the inhomogeneous radioactivity uptake in the blood pool image in either hand were characteristic findings of the patients with RP (p < 0.001).. (99m)Tc-HDP digital blood flow scintigraphy after one-hand chilling is a noninvasive, accurate, and quantitative method to evaluate RP.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Autoantibodies; Cold Temperature; Female; Fingers; Gated Blood-Pool Imaging; Humans; Immersion; Male; Middle Aged; Raynaud Disease; Regional Blood Flow; Technetium Tc 99m Medronate; Young Adult

We evaluated the predictive value of dynamic blood flow scintigraphy with

Topics: Chills; Diphosphonates; Fingers; Hand; Humans; Radionuclide Imaging; Raynaud Disease; Technetium Tc 99m Medronate

Topics: Adult; Female; Fibromuscular Dysplasia; Hand; Humans; Radionuclide Imaging; Radiopharmaceuticals; Raynaud Disease; Technetium Tc 99m Medronate

Topics: Adult; Autonomic Nerve Block; Behcet Syndrome; Humans; Male; Radionuclide Imaging; Raynaud Disease; Technetium Tc 99m Medronate

A variety of methods were used to establish objective diagnostic criteria of Raynaud's phenomenon. We intended to introduce another method, using radionuclide (Tc-99m methylene diphosphonate) scintigraphy, which is more objective, simple and economical than the past methods.. The finger blood flow with radionuclide scintigraphy was evaluated in 10 patients of Raynaud's syndrome, 12 patients of connective disease without Raynaud's symptoms, and 20 normal persons. After immersing one hand in ice water (4 degrees C) for 30 seconds, the hand was exposed to 22 degrees C room air for 15 minutes, and then the patients received the intravenous (IV) bolus of 20 microCi of Tc-99m methylene diphosphonate (MDP). At the same time, scintigraphic image of both hands started with the region of interest, including the second, third, fourth and fifth fingers distal to the metacarpophalangeal (MCP) joints. Computer recording of the counts in the region of interest every 2 seconds for 310 seconds was started on IV bolus injection.. The 310 seconds cumulative digital blood flow ratio of cold exposed hand to room air exposed hand was significantly lower in Raynaud's group (p < 0.001), and the ratio of initial slope of activity curve was also lower in the Raynaud's group (p < 0.001). Of the 8 patients showing Raynaud's syndrome, 4 patients of scleroderma and 1 patient of multiple myeloma showed no improvement of finger blood flow in the cold exposed hand after 2 weeks of pharmacological therapy, but 1 patient of mixed connective tissue disease, 1 patient of Behcet's syndrome and 1 patient of SLE showed much improved finger blood flow after combined administration of vasodilator, calcium channel blockers and antiplatelet drugs.. The evaluation of finger blood flow with 99mTc-MDP could be considered to be one of the simple, economical and new methods that can be used in the follow-up, objective assessment of therapeutic effect, and giving an aid in the study of the pathophysiology of the Raynaud's phenomenon.

Topics: Adult; Female; Fingers; Humans; Male; Middle Aged; Radionuclide Imaging; Raynaud Disease; Regional Blood Flow; Technetium Tc 99m Medronate

Bone and joint imaging with 99mTc-MDP was carried out in 17 patients with vibration disease. A comparison was made between bone scintigraphy and radiography in the regions frequently involved: cervical spine, elbow joint, wrist joint, and bone of hand. These results suggested that radiography was superior to scintigraphy in the detection of osseous changes of cervical spine, while scintigraphy was superior to radiography in the case of wrist joint and bone of hand. 99mTc-MDP joint imaging was found to be more sensitive in the detection of involvement in peripheral joints (especially metacarpal, proximal, and distal interphalangeal joints) than radiography, but it is nonspecific. Therefore, regions of increased uptake should be radiographed to determine whether other causative factors exist.

Topics: Adult; Arthrography; Bone and Bones; Diphosphonates; Elbow Joint; Hand; Humans; Joints; Male; Middle Aged; Radionuclide Imaging; Raynaud Disease; Spine; Technetium; Technetium Tc 99m Medronate; Vibration; Wrist Joint

Three-phase radionuclide scintigraphy of the hand was performed on 116 patients. Normal and abnormal patterns for radionuclide angiography, immediate post-injection blood-pool images, and delayed scans (3-4 hr.) were established. Of 80 patients with normal circulation, 61 (76%) had equal radial and ulnar artery flow bilaterally, while in 19 (24%) either the radial or ulnar artery was dominant. Abnormal studies were grouped into three categories: suspected vascular lesions (Group I), pain of uncertain etiology (Group II), and patients evaluated before and after reconstructive surgery (Group III). The diagnosis was correct in 89% of the patients in Group I (34/38), 89% of those in Group II (57/64), and all of those in Group III (14/14). Three-phase scintigraphy of the hand yields significant information about perfusion and bone metabolism.

Topics: Adolescent; Adult; Aged; Arteriovenous Malformations; Arthritis; Bone Neoplasms; Child; Child, Preschool; Diphosphonates; Female; Hand; Hand Injuries; Hemangioma; Humans; Male; Middle Aged; Radionuclide Imaging; Raynaud Disease; Reference Values; Regional Blood Flow; Technetium; Technetium Tc 99m Medronate; Thrombosis