PURPOSE: The aim of this study was to evaluate the usefulness of adenosine stress MR imaging for assessment of LV function and regional wall motion abnormality in patients with ischemic heart disease. . MATERIAL AND METHODS: We identified 10 consecutive patients who underwent rest /stress adenosine gated MRI and rest/stress Tl-201 gated SPECT within 2 weeks at least. Left ventricular ejection fraction (LVEF), LV end-systolic volume (LVESV), and LV end-diastolic volume (LVEDV) were measured. Also, Regional wall motion was scored by both adenosine stress MRI and gated SPECT on rest/ stress state. RESULTS: Adenosine stress MRI and gated SPECT show good correlation for all parameters. With gated SPECT, there was underestimation of all parameters. At stress state, Mean 짹 SD of LVEF, LVESV, and LVEDV for MRI were 51짹12%, 69짹12ml, and 125짹57ml, respectively, and those for gated SPECT were 45짹11%, 52짹41ml, and 81짹52, respectively. At rest state, Mean 짹 SD of LVEF, LVESV, and LVEDV for MRI were 48짹14%, 69짹15ml, and 118짹62ml, respectively, and those for gated SPECT were 46짹12%, 49짹39ml, and 77짹56 respectively. The relationship between the summed wall motion scores was excellent(y=0.83x + 1.20; r=0.90; P<0.01). CONCLUSION: Adenosine stress MRI is useful for assessment of LV function and regional wall motion abnormality in patients with ischemic heart disease.