In a community hospital, we correlated results of thallium 201 myocardial scintigraphy with coronary arteriographic data in 79 patients. Scintigraphy was 92percnt; sensitive and 85percnt; specific in detecting coronary artery disease. There were no false-negative scintigrams in patients with double or triple vessel disease. The most important factors determining sensitivity of the method in detecting individual coronary stenoses were (1) location of the stenosis in the coronary tree, (2) number of vessels involved, and (3) degree of obstruction. Higher prevalence of perfusion defects in areas of 90percnt; to 99percnt; stenosis as compared with 50percnt; to 89percnt; lesions was of borderline statistical significance (86percnt; vs 59percnt;; P equals; .06). Myocardial perfusion scintigraphy was unable to predict the number of significantly narrowed coronary vessels. Predictive value of a perfusion defect for a significant coronary stenosis was 87percnt; for anterior, 88percnt; for septal, 90percnt; for lateral, 89percnt; for posterior, and 78percnt; for inferior segment. We conclude that segmental analysis of myocardial scintigrams may be of value in a community hospital.
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