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The Journal of Nuclear Medicine Vol. 39 No. 3 408-410
© 1998 by Society of Nuclear Medicine
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Combined Thallium-201 Myocardial with Technetium-99m-HMPAO Brain SPECT: Myocardial Ischemia Induced by Acetazolamide in Severe Coronary Artery Disease

Yoriko Shimotsu, Kohei Hayashida, Yoshiaki Hirose, Norihiko Kume and Tsunehiko Nishimura

Department of Radiology, National Cardiovascular Center, Osaka; Division of Tracer Kinetics, Biomedicai Research Center, Osaka University Medical School, Osaka, Japan

Correspondence: For correspondence or reprints contact: Kohei Hayashida, MD, National Cardiovascular Center, Department of Radiology, 5–7-1 Fujishirodai, Suita, Osaka, 565-8565 Japan.

ABSTRACT

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 201TI 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 201TI myocardial imaging with ACZ, as did that with dipyridamole. Tecnnetium-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.

Key Words: acetazolamide • myocardial ischemia • coronary artery disease • cerebrovascular disease • SPECT






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Copyright © 1998 by the Society of Nuclear Medicine.