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Fig. 2D. —75-year-old man with right internal carotid artery stenosis. ¹³³Xe SPECT image obtained after administration of acetazolamide shows no increase in cerebral blood flow in right middle cerebral artery territory despite presence of acetazolamide. Cerebral blood flow values changed to 26 mL/100 g per minute in right middle cerebral artery territory and 44 mL/100 g per minute in left middle cerebral artery territory. Thus, percentage of cerebral blood flow increase after administration of acetazolamide is -13% in right and +38% in left middle cerebral artery territories, respectively. Mean transit time and ¹³³Xe SPECT images represent impaired cerebral perfusion reserve in right middle cerebral artery territory. R = right, L = left.