Doppler spectral waveform analysis of arteries of the hand in patients with Raynaud's phenomenon as compared with healthy subjects

OBJECTIVE. We sought to characterize and compare the blood flow patterns of peripheral arteries of the hand in patients with Raynaud's phenomenon and in healthy subjects. SUBJECTS AND METHODS. We used Doppler sonography to assess the blood flow p attern of the proper palmar digital artery and the deep radial arch in the hands of 79 healthy subjects and 24 patients with primary and secondary Ray naud's phenomenon. We determined the resistive index, pulsatility index, pe ak systolic velocity, and end-diastolic velocity of these peripheral arteri es at rest and after cold immersion. RESULTS. The proper palmar digital artery of healthy subjects showed higher end-diastolic velocities and lower resistive indexes than did the deep rad ial arch. Compared with healthy subjects, patients with Raynaud's phenomeno n had higher resistive and pulsatility indexes but lower peak systolic and end-diastolic velocities in these arteries. Accordingly, the differences in end-diastolic velocity and resistive index seen in the two peripheral arte ries of healthy subjects were not seen in patients with Raynaud's phenomeno n. Analysis of receiver operating characteristic curves showed high diagnos tic accuracy in detecting the disease. Cold-immersion studies revealed that for the proper palmar digital arteries throughout the time after immersion , all these Doppler parameters were significantly lower for the velocities and higher for the indexes in patients with Raynaud's phenomenon than in he althy subjects. CONCLUSION. Taken together, these results suggest a legitimate role for Dop pler sonography in the assessment of Raynaud's phenomenon.