Application Of Color Doppler Ultrasonography In Hemodynamic Evaluation Of Arteries Of The Hand In Patients With Raynaud's Phenomenon: A Preliminary Study

Purpose The purpose of this study was to compare the hemodynamics ofarteries of the hand in patients with Raynaud's phenomenon(RP) and in healthy subjects, and to preliminarily determine the feasibility of differentiating patients with Raynaud's phenomenon from healthy subjects by color Doppler ultrasonography with cold immersion study, and to provide objective standards of hemodynamics for diagnosis of RP.Methods Color Doppler ultrasonography was applied to 26 healthysubjects(26 left hands) and 18 patients with RP(15 left hands and 9 right hands ).The hemo-dynamics of the ulnar proper palmer digital artery of index finger(UPPDA) and the deep radial arch(DRA) before cold immersion were examined. The hemodynamic indicators of UPPDA were measured before cold immersion(T₀), 1 minute(T₁),3 minute(T₃),5minute(T₅),7minute(T₇), 9minute(T₉),11minute(T₁₁) after cold immersion. The peak systolic velocity (SPV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI) were determined. The hemodynamics of UPPDA and DRA before cold immersion and UPPDA after cold immersion of the two groups were compared. The hemodynamic indicators of left UPPDA and DRA of 5 healthy subjects and 5 patients with RP were measured three times, every 5 minutes once, and the repeatability was analyzed.Results The study variation and the number of distinct categories of therepeated measurements reflected an acceptable repeatability. There were no significant differences in SPV of UPPDA and DRA in control group (p=0.123) . EDV of UPPDA in control group was significantly higher, but RI,PI were significantly lower than those of DRA (p<0.05) . There were no significant differences in hemodynamic indicators of UPPDA and DRA in RP group (p>0.05) . The blood velocities of DRA and UPPDA in RP group were lower than those in control group, but RI and PI of UPPDA were higher than those in control group(p<0.05). SPV,EDV,RI,PI of UPPDA in control group recovered to pre-cooling values by 3 min, SPV,EDV at T₃-T₁₁ were a little higher than pre-cooling values (p<0.05) . SPV of patients with RP remained significantly lower than pre-cooling values until the end of the test (p<0.05), EDV,RI,PI recovered to pre-cooling values by 11,11,9 min respectively. The differences between after-cooling and pre-cooling values in the two groups were compared. There were significant differences in SPV,EDV at T₃-T₉, in RI at T₁-T₇, in PI at T₃ in the two groups (p<0.05).Conclusion The hemodynamics of UPPDA and DRA in the two groups were significantly different. The recovering time after cold immersion in RP group was significantly prolonged compared with control group. The variational trend of hemodynamic indicators after cold immersion in the two groups were significantly different. Color Doppler ultrasonography with cold immersion study could differentiate healthy subjects from patients with RP, and it could provide objective standards of hemodynamics for the diagnosis of RP.