The aim of this study was the determination of blood flow characteristics and parameters in the hand arteries of patients with primary Raynaud's phenomenon (pRP) and comparison with the results of healthy subjects. The diameter, resistive index and flow volume of the digital, ulnar and radial arteries of the patients with pRP and the control group were measured at rest and after cold provocation. The flow starting time (FST) in the digital artery and the flow normalising time (FNT) of all three arteries were also recorded after cold provocation. The diameter and flow volume of the digital and ulnar arteries of the patients were lower at rest, but resistive index was significantly high in all arteries. After cold provocation, the diameters of the radial and ulnar arteries and the flow volume of the digital arteries of the patients were significantly lower than those of the controls. The mean FST was 3.6 +/- 3.8 min for the patients and 0.9 +/- 1.2 min for the controls. The mean FNT was significantly longer in all the arteries of the patients; FNT cutoff times for the radial, ulnar and digital arteries were 6.5, 5.5 and 6.5 min, respectively. The measurements of the diameter, resistive index and flow volume of all the arteries measured before and after cold provocation as well as FST of the digital artery and FNT of all the arteries may facilitate in providing additional information in pRP patients.
The diameter of the radial and distal arteries; flow volume; and flow volume normalizing time of the digital, ulnar, and radial arteries' flow starting time in the digital artery may be helpful in distinguishing between primary RP and secondary RP with high sensitivity and specificity values. These parameters may also facilitate objective follow-up of treatment. The noninvasive nature of Doppler sonography is an additional advantage, and there is no need for extra hardware or software.
A cute blindness during hemodialysis is very rare. It is important to fi nd out the real etiology before beginning treatment. The etiology might include anterior or posterior ischemic optic neuropathy, acute cerebral infarction, or reversible posterior encephalopathy syndrome (RPES). We sought to emphasize the importance of diffusionweighted imaging (DWI), apparent diffusion coeffi cient (ADC) mapping, and magnetic resonance spectroscopy (MRS) for diagnosis. Close collaboration among nephrologists, neuro-ophthalmologists, and radiologists is important in this interdisciplinary emergency.
Case ReportA 48-year-old woman with chronic renal failure developed acute blindness during hemodialysis. Cranial computerized tomography (CT) was reported as normal. For this reason, an emergent cranial magnetic resonance imaging (MRI), as well as a DWI, ADC mapping, and MRS were performed in less than 6 hours after the incident on a 1.5 T whole body MRI system (Excite, General Electric, Milwaukee, Wisc.) with a 33 mT/m maximum ABSTRACT: Acute blindness related to hemodialysis is very rare. It is important to fi nd out the real etiology before beginning treatment. In this case, we sought to emphasize the importance of diffusion-weighted imaging, apparent diffusion coeffi cient mapping, and magnetic resonance spectroscopy for diagnosis. Close collaboration among nephrologists, neuro-ophthalmologists, and radiologists is important in this interdisciplinary emergency.
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