Carotid artery disease: evaluation with acetazolamide-enhanced Tc-99m HMPAO SPECT

Radiology. 1992 Feb;182(2):461-6. doi: 10.1148/radiology.182.2.1732965.


Sixty patients were studied for carotid artery disease and were further evaluated with hexamethyl-propyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) both at baseline (with the patient resting) and after administration of acetazolamide (ACZ). Of these 60 patients, 58 (97%) had symptoms and 49 (82%) had stenoses greater than 70% in at least one internal carotid vessel. Nine patients (15%) had symmetric findings on baseline examinations and at SPECT with ACZ. Thirty-two patients (53%) had asymmetric findings on baseline, but in 24 of these patients (75%) additional lesions were observed after ACZ administration. Nineteen patients (32%) had asymmetric findings only after ACZ was administered. HMPAO SPECT with ACZ allows detection of diminished cerebral perfusion reserve that is not found when HMPAO SPECT is performed with the patient at rest. This procedure helps provide an objective evaluation of the hemodynamic effects of carotid stenosis.

MeSH terms

  • Acetazolamide*
  • Adult
  • Aged
  • Aged, 80 and over
  • Arterial Occlusive Diseases / diagnostic imaging*
  • Arterial Occlusive Diseases / physiopathology
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / physiopathology
  • Cerebrovascular Circulation / drug effects
  • Cerebrovascular Disorders / etiology
  • Female
  • Humans
  • Ischemic Attack, Transient / diagnostic imaging
  • Ischemic Attack, Transient / drug therapy
  • Ischemic Attack, Transient / physiopathology
  • Male
  • Middle Aged
  • Organotechnetium Compounds*
  • Oximes*
  • Technetium Tc 99m Exametazime
  • Tomography, Emission-Computed, Single-Photon*


  • Organotechnetium Compounds
  • Oximes
  • Technetium Tc 99m Exametazime
  • Acetazolamide