Assessment of microvascular changes in Raynaud's phenomenon and connective tissue disease using colour doppler ultrasound.
OBJECTIVE
We used colour Doppler ultrasound (CDU) to differentiate primary from secondary Raynaud's phenomenon (pRP and sRP, respectively) and to assess digital vascular damage in patients with connective tissue disease (CTD).


METHODS
Vascularity in the nailbeds of 15 healthy controls and 35 patients with CTD (systemic sclerosis or systemic lupus erythematosus) was quantified using a multi-D array transducer before and after cold and warm challenge, respectively. The results were compared with the clinically evaluated initial skin lesions. Vascularity was compared similarly between 10 pRP and 22 sRP patients.


RESULTS
Vascularity at ambient temperature differed between healthy subjects and sRP patients as well as between healthy subjects and CTD patients without initial skin lesions. Patients with pRP had normal vascularity at ambient temperature but differed from healthy controls in response to a dynamic temperature challenge. CDU confirmed the clinical evaluation in 89.4% of the patients with RP and in 78.0% of the skin lesions.


CONCLUSIONS
The novel CDU technique presented here makes it possible to discriminate between pRP and sRP and to quantify vascular changes in CTD patients.
Keberle
M
M
Institut für Röntgendiagnostik, University of Würzburg, Würzburg, Germany.
Tony
H P
HP
Jahns
R
R
Hau
M
M
Haerten
R
R
Jenett
M
M
D000328:Adult; D003080:Cold Temperature; D003937:Diagnosis, Differential; D005260:Female; D005385:Fingers / Q000098:blood supply; D006358:Hot Temperature; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D017534:Radial Artery; D011928:Raynaud Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D012039:Regional Blood Flow; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D017535:Ulnar Artery; D018615:Ultrasonography, Doppler, Color