Abnormality Detection in MRI as a Diagnostic Tool for Raynaud's Phenomenon

Abstract

Background Raynaud's phenomenon (RP), a disorder of episodic vasospasms found in the digits, is triggered by exposure to cold or stress. Typically, RP presents as a triphasic color pattern from pallor to cyanosis to rubor. Current diagnostic tools include nailfold capillaroscopy, thermography, color doppler ultrasound, cold stimulation test, and clinical findings. Due to expense, lack of availability, and reproducibility of results, there is no present universal, gold standard diagnostic method. Magnetic Resonance Imaging (MRI) has been used for diagnosis or prognosis, with associated abnormalities in RP patients. This research analyzes the potential use of MRI as an accurate and universal diagnostic tool for RP. Methods A search of PubMed and Google Scholar databases was conducted using the search terms: “Abnormal MRI, Raynaud's”, “MRI, Raynaud's Syndrome”, “Magnetic resonance, Raynaud's”, “Magnetic resonance angiography, Raynaud's”. A total of 13 papers were found, including 99 cases of Raynaud's patients, for analysis and incorporation into this review. Articles presenting cases of Raynaud's symptoms secondary to tumors or cysts were excluded. Results 99 patients (average age = 39.58 years old, age range = 18-80; gender = 54 female, 12 male, 33 unspecified), presented with RP with 98 MRIs completed. 30 patients presented with Primary Raynaud's Syndrome (PRS) and 69 presented with Secondary Raynaud's Syndrome (SRS). 88.78% of MRIs were abnormal. 84.06% of SRS patients had abnormal MRI results. SRS patients with normal results were limited to scans of the brain (3 with underlying systemic lupus erythematosus; 8 with systemic sclerosis). 100% of the PRS patients had abnormal MRI results. Conclusion Majority of MRIs identified abnormalities associated with RP, suggesting its potential as a diagnostic tool for RP. Abnormal MRI results were more accurate in identifying RP for PRS (100%) compared to SRS (84.06%). MRIs were found to be applicable in large patient populations, non-restrictive of age or gender. A limitation to the study included multiple, overlapping terms (RP, Raynaud's disease and Raynaud's syndrome) found in manuscripts, which contribute to confounding of results. Additionally, the various MRI locations (eg., extremity, heart, brain) could impact findings.