Shimotsu Y, Hayashida K, Hirose Y, Kume N, Nishimura T
Department of Radiology, National Cardiovascular Center, Suita, Osaka, Japan.
J Nucl Med. 1998 Mar;39(3):408-10.
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.
由于脑血管疾病患者冠状动脉搭桥手术的围手术期死亡率很高，因此术前评估脑血管风险至关重要。乙酰唑胺（ACZ）被应用于脑单光子发射计算机断层扫描（SPECT）以评估血管储备，ACZ负荷脑显像有助于预测围手术期脑血管事件。我们对一名患有严重冠状动脉疾病的患者同时进行了铊-201心肌和锝-99m-六甲基丙烯胺肟（HMPAO）脑SPECT负荷试验，结果发现该患者ACZ负荷下的铊-201心肌显像出现异常，双嘧达莫负荷试验时也出现了同样的异常情况。锝-99m-HMPAO脑SPECT未显示缺损。ACZ负荷脑SPECT显示冠状动脉血管储备不良区域，这提示严重冠状动脉疾病患者中ACZ诱发了心肌缺血。
