Usefullness of flow composite image in Raynaud scan(201Tl) Department of Nuclear Medicine, East-West Neo Medical Center , Kyung-Hee University Dae Yeon Kim, Gyoo Seol Shin, Eun Jeong Oh, Kun Jae Kim

Raynaud syndrome Report : Maurice Raynaud of France, 1862 Rates : 10 % of population : Female > Male [9 times]

Raynaud syndrome Primary Raynaud’s phenomenon (Raynaud’s disease) - cannot look up the cause - bilateral - about 15~30 min Secondary Raynaud’s phenomenon Raynaud’s phenomenon Raynaud’s disease 95% 5% - affected by diseases - may be unilateral - fast progress and more severe

Triphasic color change Raynaud phenomenon Triphasic color change Triphasic color changes Precipitate by cold emotional stress Triphasic color change : pallor  cyanosis  rubber Pallor Cyanosis Rubber

Diagnosis of raynaud phenomenon Angiography Raynaud scan - 201 Tl Biochemistry test Nailfold capillaroscopy (NFC) Power doppler ultrasonography (PDU) Antinuclear antibody test Rheumatoid arthritis factor blood test Diagnosis of raynaud phenomenon

Target and Term Target Term 29 patients (male : 8, female : 21) Raynaud’s syndrome Hx. Feb. 2008 ~ Aug. 2009 29 patients (male : 8, female : 21) EWNMC vascular surgery Target Term

LEHR (Low energy high resolution) Acquisition Machine Zoom factor Collimator Philips Gamma Camera Forte A - Z Philips PEGASYS processing system LEHR (Low energy high resolution) 1.00 x (Full Field)

Acquisition Matrix size 64 x 64 Flow Blood pool Delay 155 f / 2 sec

Method Flow Blood pool Delay

Method Flow Composite Blood pool Delay

Method Comparison with composite image and delay image in raynaud scan Flow Blood pool Delay Blood pool Delay Flow flow  composite + Composite Blood pool Delay

Lt hand count/ Rt hand count Rate Result Lt hand count/ Rt hand count Rate rate 3 2 1 patient composite count rate Blood pool count rate Delay count rate

Result Comparison Section Group 1 Group 2 Group 3 Part Composite Blood pool Delay Count ratio (Rt. / Lt.) mean 1.25 ± 0.39 1.20 ± 0.33 1.11 ± 0.17 Comparison Group 2 & 3 p = 0.029 p < 0.05 Group 1 & 2 p = 0.038 p < 0.05 Group 1 & 3 p = 0.016 p < 0.05

Conclusion Flow Blood pool Delay Visual Comparison Classification Composite Useful Diagnosis

Question And Answer Q&A