Objective The aim of this study was to investigate the clinical value of myocardial perfusion imaging (MPI) in evaluation of patients with symptomatic myocardial bridge and mural coronary artery complex (MB-MCA). Methods Imaging data of 98 patients with symptomatic MB receiving 256-slice spiral CTCA and SPECT/CT MPI were retrospectively analyzed .CTCA and MPI were completed within one week .Results ①Ninety-eight symptomatic MB-MCA cases were included , consisting of 9 cases of superficial MB -MCA, 89 cases of deep MB -MCA.There were 45 cases with positive MPI findings .There was a statistically significant difference (χ2 =4.835, P=0.028) in the MPI re-sult between deep -in MB-MCA and superficial MB -MCA;②Among 98 patients with symptomatic MB-MCA, 91 ca-ses had the lesion in LAD, 4 in LCX, 3 in RCA.Seventy-seven cases (79%, 77/98) were found with is the lesion lo-cated in the middle LAD.Perfusion abnormalities were detected via MPI in 41 patients (42%, 41/98) with MB-MCA in LAD, in which myocardial ischemia due to stenosis in middle LAD was found in 34 cases, accounting for 76%(34/45) of cases with abnormal myocardial perfusion;③Among 98 cases with symptomatic MB -MCA, there were 30 cases with MCA with systolic stenosis and 68 cases without stenosis;MPI was positive in 45 cases.Significant differences were found in presence of perfusion abnormalities between MB -MCA patients with systolic stenosis and those without systolic stenosis (χ2 =5.280, P=0.022).Conclusion Myocardial ischemia due to MB mostly occurs in patients with deep MB -MCA and may be caused mainly by systolic stenosis in MCA .MB-MCA and perfusion abnormalities are commonly found in the mid LAD.%目的：探讨心肌灌注显像对症状性冠状动脉心肌桥（ MB－MCA）患者的临床价值。方法回顾98例MB－MCA患者的256层CT冠状动脉造影（CTCA）和SPECT／CT MPI结果并进行统计分析，CTCA和MPI在1周内完成。结果（1）98例症状性MB－MCA患者，包括浅表型MB－MCA 9例，深在型MB－MCA 89例，其中MPI阳性者45例。深在型MB－MCA和浅表型MB－MCA MPI结果存在统计学差异（χ2＝4.835，P＝0.028）；（2）98例症状性MB－MCA患者，包括左前降支（LAD）91例，左回旋支（LCX）4例，右冠状动脉（RCA）3例，其中位于LAD中段者77例（79％，77／98）。 MPI发现LAD的MB－MCA患者中有41例心肌血液供应异常（42％，41／98），其中LAD中段心肌缺血者34例，占所有心肌血液供应异常者的76％（34／45）；（3）98例症状性MB－MCA患者中，MCA伴收缩期狭窄30例，无狭窄68例；MPI阳性45例；MB－MCA收缩期有无狭窄与心肌血流灌注异常之间存在统计学差异（χ2＝5.280，P＝0.022）。结论 MB心肌缺血主要发生在深在型MB－MCA患者，左前降支中段是MB－MCA和引起心肌血流灌注异常的好发部位，且MCA收缩期狭窄可能是MB引起心肌缺血的主要原因。
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