用锝-99m亚甲基二膦酸盐（Tc-99m MDP）评估手指血流量。

Evaluation of finger blood flow with Tc-99m MDP (methylene diphosphonate).

作者信息

Bang S H, Oh Y S, Park H J, Lee T K, Yang J S, Lee S M, Min K W, Park W

机构信息

Department of Internal Medicine, National Medical Center, Seoul, Korea.

出版信息

Korean J Intern Med. 1992 Jul;7(2):94-101. doi: 10.3904/kjim.1992.7.2.94.

DOI:10.3904/kjim.1992.7.2.94

PMID:1306078

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4532110/

Abstract

BACKGROUND

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.

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

人们采用了多种方法来建立雷诺现象的客观诊断标准。我们打算引入另一种方法，即使用放射性核素（锝-99m亚甲基二膦酸盐）闪烁扫描术，该方法比以往的方法更客观、简单且经济。

方法

对10例雷诺综合征患者、12例无雷诺症状的结缔组织病患者和20名正常人进行放射性核素闪烁扫描术评估手指血流情况。将一只手浸入4℃冰水中30秒后，将手暴露于22℃的室内空气中15分钟，然后患者静脉推注20微居里的锝-99m亚甲基二膦酸盐（MDP）。与此同时，双手的闪烁扫描图像从感兴趣区域开始，包括掌指关节（MCP）远端的第二、第三、第四和第五指。静脉推注后开始每2秒对感兴趣区域的计数进行计算机记录，持续310秒。

结果

雷诺组中，冷暴露手与室温暴露手的310秒累积手指血流比显著降低（p<0.001），雷诺组中活性曲线的初始斜率比也较低（p<0.001）。在8例表现为雷诺综合征的患者中，4例硬皮病患者和1例多发性骨髓瘤患者在药物治疗2周后，冷暴露手的手指血流无改善，但1例混合性结缔组织病患者、1例白塞病患者和1例系统性红斑狼疮患者在联合使用血管扩张剂、钙通道阻滞剂和抗血小板药物后，手指血流有明显改善。