ObjectiveTo analyze the roles of adenosine stress myocardial perfusion tomographic imaging(ASMPTI) in diagnosis of coronary artery diseases (CAD) and its significance for evaluating the sites,numbers,and stenosis of involved vessels. MethodsASMPTI was performed in 116 elderly patients suspicious for CAD. Adenosine was infused intravenously within 6min 〔140μg/(kg·min)〕. At 3 min after adenosine infusion,740 MBq of 99mTc-methoxy-isobatyl-isonitrile (MIBI) was injected intravenously. Single photon emission computed tomography myocardial perfusin imaging was obtained 1.5h after adenosine infusion. If the findings were abnormal,rest myocardial perfusion imaging would be performed next day. Coronary angiography (CAG) was performed in all patients within 1 week after myocardial imaging. ResultsAmong 116 cases,coronary artery stenosis was demonstrated by CAG in 73 patients,including 22 patients with single vessel lesions,32 with double vessel lesions and 19 with triple vessel lesions. The sensitivity,specificity and accuracy of ASMPTI for CAD were 87.7%,72.1% and 65.5%,respectively. The sensitivity for diagnosing single,double and triple vessel lesions was 59.1%,84.4% and 89.5% respectively (P<0.05). The sensitivity for diagnosing 50%-75% diameter stenosis was 57.1%,and that for diameter stenosis ≥75% was 89.4%,with significant difference between the two groups(P<0.05). The positive rate of ASMPTI was high for left anterior desending coronary artery involved coronary stenosis,either for single,double,or triple vessel lesions. As for 17 cases undergoing introvascular ultrasound,7 cases had plaque area >50% or lumen area <4mm2,and had off-center or unstable plaque. They received percutaneous coronary intervention. The ASMPTI was all positive in these 7 cases. ConclusionThe sensitivity of ASMPTI is related to coronary artery stenosis degree and numbers of involved vessels. The sensitivity for serious stenosis and double or triple vessel lesions is high,while that for mild or moderate stenosis and single vessel lesions is low. The positive concordance rate of ASMPTI for left anterior descending coronary artery is higher than that for left circumflex coronary artery and right coronary artery. It also has some values in predicting the borderline lesions.