FRI0467 The relationship between 99mtc-pertechnetate hand perfusion scintigraphy and naifolid capilloscopy in systemic sclerosis patients: a pilot study

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 762
• Main Authors: Pavlov-Dolijanovic, S.R., Petrovic, N., Vujasinovic Stupar, N., Damjanov, N., Radunovic, G., Zugic, V., Babic, D., Sobic-Saranovic, D., Artiko, V.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Blood flow; Disease; Gastroenterology; Medicine; Microvasculature; Motility; Perfusion; Rheumatic diseases; Rheumatology; Scintigraphy; Scleroderma; Skin diseases; Statistical analysis; Systemic sclerosis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.4268

BackgroundThe aim of this study was to assess possible relationship between the altered blood perfusion at hands analysed by 99mTc-pertechnetate hand perfusion scintigraphy (99mTcPHPS) and, morphological microvascular abnormalities detected by nailfold capillaroscopy (NC) in SSc patients.MethodsThe study group consisted of 25 patients with SSc (14 with diffuse SSc, and 11 with limited SSc) and 28 control subjects (18 patients with primary RP, and10 healthy individuals). NC and 99mTcPHPS was performed in all the groups examined. The capillaroscopic pattern was classsified as normal or scleroderma (”early”, ”active”, or ”late”) pattern. Gamma-camera dynamic first-pass study during the first 60 s and a static scintigraphy after 5 min were recorded following a bolus injection of 99m Tc-pertechnetate via a cubital vein. Regions of interest were drawn on the summed images around the fingers and the palmar region. The fingers-to-palm ratios were then calculated.ResultsSSc patients showed a significantly lower blood flow (BF) and blood pool (BP), (0.43±0.21 vs 0.36±0.07, respectively), than PRP patients (0.45±0.18 vs 0.42±0.06, respectively) and healthy subjects (0.58±0.19 vs 0.44±0.06, respectively), (p-value 0.039 vs 0.004, respectively). A gradual decrease of BF and BP was found in SSc patients with progressive severity of NVC patterns of microangiopathy [”early” (0.49±0.03 vs 0.39±0.04, respectively), ”active” (0.43±0.11 vs 0.38±0.06, respectively) or ”late” (0.40±0.28 vs 0.36±0.08, respectively), (p- value 0.462 vs 0.728 respectively], but these differences were not statistically significant. Patients with diffuse SSc showed lower BF, and higher BP (0.42±0.26 vs 0.37±0.07, respectively) than those with limited SSc, (0.44±0.14 vs 0.35±0.064, respectively), but this differences is not statistical significantly (p=0.76 vs p=0.53, respectively). There was no significant correlation between BF and BP values and type of SSc (limited or diffuse) (r=−0.06, p=0.77; r=0.13, p=0.54, respectively) as well as three microangiopathy patterns (r=−0.253, p=0.22; r=– 0.13, p=0.54, respectively).ConclusionsNC represents the best method to analyse microvascular damage in rheumatic diseases, especially SSc. 99m TcPHPS improves the evaluation of vascular damage in SSc patients. There is no direct relationship between these two methods, but one method complements another in the study of vascular damage in SSc patients.Disclosure of InterestNone declared