Objective:To explore the usefulness of 99mTc-MIBI single photon emission computed tomography(SPECT)combined with coronary angiography (CAG) in diagnosis and management of coronary artery disease (CAD). Methods:One hundred and seventy-six suspected patients with coronary artery disease underwent CAG or CAG plus SPECT. The management strategy and revascularization procedure(Percutaneous transluminal coronary angioplasty[PTCA]vs. coronary artery bypass graft surgery[CABG]) were prospectively selected on the basis of a combination of CAG,SPECT and the approval of diagnostic criteria of CAD of the Ministry of Health. Patients received PTCA or CABG were retested with SPECT in 1~3 months after treatment. The results were compared for exploring the role and significance of them in preoperative diagnosis and postoperative follow-up for CAD. Results:A total of 176 patients underwent CAG,of which 113 patients were performed SPECT for one week before CAG. The results showed that 138 patients of CAD were found from them. The results of patients with CAD were analyzed,the diagnostic sensitivity,specificity and accuracy of CAG were 93.4%(129/138),97.4%(37/38)and 94.3%(166/176),respectively. The ratios of SPECT were 85.2%(69/81),90.6%(29/32)and 86.7%(98/113)and of CAG + SPECT(as long as one is abnormal,it should be deemed positive) were 100%(81/81),87.5%(28/32)and 96.5%(109/113),respectively. Sixty-five patients received SPECT within 3 months after treatment(PTCA 63,CABG 2). It was showed that △STR and △LVEF(Percentual Systolic Wall Thickening and left ventricular ejection fraction change between pre- and post- operation)were related to chest pain relief of CAD patients. Conclusion: Combination of SPECT and CAG can improve the diagnostic sensitivity and accuracy of CAD;SPECT can be intuitive,quantifiable,repeatable and convenient to reflect the improvement of clinical symptoms of CAD patients after treatment.