背景　鉈－201心肌灌注攝影為一常用於冠心症診斷之工具，然而常有一些情形，例如小區域之缺氧、可逆性再分佈及衰減效應造成之灌流不足，約可能使判讀發生困難。方法　我們希望使用心節律門閥鉈壓力攝影加入原來檢查顯示邊綠性結果之病例中，看是否可以增加冠心症之正確診斷。2004年l月至11月共512位受檢病人中，有69位呈現邊綠性結果，其中32位接受了心導管檢查，本實驗即取此32名病例做分析。結果　鉈－201心肌灌注攝影32名邊綠性病例中，21位有顯著冠心症，11位無；此32名病例若再加上心節律門閥鉈壓力攝影檢查後，不正常變化之病例共25位，當中21位有顯著冠心症，4位無，而無不正常變化之7名病例中均無冠心症；換言之，本研究從邊緣病例中，找出32名，將這32名病例皆實施心導管手術，其中有11名將被誤作心導管手術，但多加了一套檢驗手續，此32名病例中僅4名可能被誤作心導管手術，可見後者比前者更能降低誤判的機率。我們使用兩母體比率差異之假設檢驗來測試此一結果，顯示假設有意義，P值=0.0166(p<0.05)。結論　心節律門閥鉈壓力攝影對鉈－201心肌灌注攝影邊緣性結果之病人，於冠心症之診斷上有極佳的參考效果。

Background: Thallium-201 myocardial perfusion scan is a commonly utilized method for detection of coronary artery disease. Although this technique is generally reliable, results can be inconclusive in some cases. The purpose of this study was to assess whether candidates for coronary angiogram could be better identified with the addition of an electrocardiographic (ECG)-gated myocardial perfusion scan to a thallium scan. Method: A total of 512 patients with suspected coronary artery disease were included in this study and received a thallium scan. In 69 patients, the results were borderline, and 32 of these 69 patients also received an ECG-gated scan and underwent coronary angiogram within one month. Results: We found that 21 of the 32 patients who underwent coronary angiogram had significant coronary artery disease. However, when an ECG-gated perfusion scan was also performed, 25 of the 32 patients had abnormal regional wall motion following the stress test. Twenty-one of these 25 patients were found to have significant coronary artery disease. Statistical analysis revealed that the ECG-gated perfusion scan in combination with the thallium scan was significantly more accurate than the thallium scan alone in borderline cases of myocardial perfusion scan (p=0.0166), with 100% sensitivity, 63.6% specificity, an 84% positive predictive rate, and a 100% negative predictive rate. Conclusions: The ECG-gated perfusion scan in combination with a thallium scan was more accurate in predicting the presence of coronary artery disease than a thallium scan alone in borderline cases of myocardial perfusion scan.