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Objective: To analyze the efficiency and clinical value of adenosine stress/rest SPECT myocardial perfusion imaging (MPI) retrospectively for evaluating abnormal myocardial blood supply.Methods: The study group included 1858 patients who were suspected or known coronary artery disease (CAD) with male 1152 and female 706.In these patients there were 373 with diabetes mellitus and 618 with hyperlipemia.All patients underwent 99Tcm-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT with adenosine infusion by standard 2-day protocol.1832 patients underwent maximum dose adenosine in stress myocardial perfusion imaging.Adenosine dose was decreasing for side-effect in 26 patients.Adenosine injection rate was 140 μg·kg-1·min-1 for 6 min with maximum stress dose according to the body weight and injecting 99Tcm-MIBI 3 min after beginning.The clinical symptom and ECG were recorded during all stress process.The patients took rest myocardial perfusion imaging next day.The myocardial perfusion imaging was performed 1.5h after injecting 99Tcm-MIBI at both stress and rest imaging.MPI studies were interpreted by two or more experienced nuclear medicine physicians.Coronary angiography was performed in all patients within one month.Results: A total of 957 had coronary artery disease with stenosis ≥50% and 901 had normal result that confirned by coronary angiography.Of the 957 patients there were 506 one-, 256 two-, 195 three-vessel stenosis.There were 1603 branch of stenosis coronary, of them 765 left anterior descending coronary artery (LAD), 399 left circumflex coronary artery (LCX), 439 right coronaryartery (RCA).A total of 1126 patients had myocardial ischemia and infarction in adenosine stress/rest SPECT myocardial perfusion imaging,and there were 1586 myocardial segments with myocardial ischemia and infarction in which there were 820,310,456 segments in LAD supply aera(anterior, anteroseptal,apex, anterolateral walls),LCX supply aera(inferolateral wall) and RCA supply aera(inferoseptal,inferior, posterior walls) respectively.Adenosine stress myocardial perfusion imaging was abnormal in 876 out of the 957 patients in coronary artery stenosis (sensitivity 91.54 %),and normal in 651 out of the 901 patients with normal angiography (specificity 72.25 %), the positive and negative predictive values were 77.80%(876/1126) and 88.93%(651/732) respectively.The sensitivity in diagnosis of branch vessel were 81.31%(622/765,LAD),56.64%(226/399,LCX) and 70.62%(310/439,RCA) respectively.The sensitivity for detection of one-, two-, three-vessel stenosis were 87.55%(443/506),94.92%(243/256) and 97.44%(190/195) respectively.The frequency of side-effects was slight and transient with the incidence of 84.12% (1563/1858), no hard cardiac events were found.Conclusions: Stress myocardial perfusion imaging with adenosine is as effective as coronary angiography for detecting CAD and has clinical value for evaluating abnormal myocardial blood supply.