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Magnetic resonance imaging (MRI) has been used in conjunction with dipyridamole induced wall motion abnormalities for the noninvasive detection of coronary artery disease (CAD). To assess the clinical usefulness of dipyridamole-MRI for the localization of CAD and to evaluate the relation between dipyridamole induced wall motion abnormalities and myocardial perfusion 33 patients with severe CAD (>70% diameter reduction) underwent MRI at rest and after dipyridamole infusion (0.75 mg dipyridamole/kg over a period of 10 minutes). All patients performed exercise stress testing and 20 patients of the study group additionally had rest and exercise stress99mTc-methoxyisobutyl-isonitrile-SPECT (MIBI-SPECT). Two patients (6%) could not be evaluated due to severe motion artifacts during dipyridamole MRI.