To evaluate the role of myocardial tomography with Tc-99m-MIBI (MB) in detecting abnormal coronary arteries, 34 patients with myocardial infarction underwent resting quantitative SPEC with MB and coronary arteriography within one month. When segmental MB uptake was < 560% of the left ventricular peak activity, there was 88% probability that a totally occluded or severely stenosed coronary artery (stenosis > 90%) was involved. There was 82% probability of finding no significant stenosis of coronary arteries in the normal myocardial segments. In the myocardial segments supplied by occluded coronary arteries, there was significantly higher MB uptake in the segments with good collateral circulation as compared with those subtended by a vessel totally occluded with poor collateral circulation (P < 0.05). The sensitivity and specificity of detecting abnormal coronary artery by quantitative analysis of myocardial tomography was 87% and 90% respectively. It is suggested that quantitative analysis of myocardial tomography with MB can differentiate between myocardial segments supplied by severely stenosed and normal coronary artery and evaluate the existence of collateral circulation.