Combined thallium-201 myocardial with technetium-99m-HMPAO brain SPECT: myocardial ischemia induced by acetazolamide in severe coronary artery disease.
Since the perioperative mortality of coronary artery bypass surgery is high in patients with cerebrovascular disease, it is crucial to assess a cerebrovascular risk before operation. Acetazolamide (ACZ) was applied to brain SPECT to evaluate the vascular reserve, and ACZ stress brain imaging was useful for predicting perioperative cerebrovascular events. We performed 201Tl myocardial and 99mTc-hexamethyl-propyleneamine oxime (HMPAO) brain SPECT with ACZ stress simultaneously to a patient with severe coronary artery disease and experienced the abnormality of 201Tl myocardial imaging with ACZ, as did that with dipyridamole. Technetium-99m-HMPAO brain SPECT showed no defect. Brain SPECT with ACZ demonstrated the region of poor coronary vascular reserve, which suggested myocardial ischemia induced by ACZ in a patient with severe coronary artery disease.
Shimotsu
Y
Y
Department of Radiology, National Cardiovascular Center, Suita, Osaka, Japan.
Hayashida
K
K
Hirose
Y
Y
Kume
N
N
Nishimura
T
T
D000086:Acetazolamide / Q000494:pharmacology; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000494:pharmacology
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D019690:Technetium Tc 99m Exametazime; D000086:Acetazolamide