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目的 评价静脉尿路造影(IVU)后的螺旋CT平扫(IVU+CT)对上尿路疾病的诊断价值.资料与方法 195例患者因临床怀疑上尿路疾病、超声(US)未能确诊而行IVU检查,从中实时选出IVU不能作明确诊断的患者作为研究对象,共71例.其中65例行立即或延迟腹部CT平扫,将原始资料传递至影像工作站做后处理,获得多平面重组(MPR)、最大密度投影(MIP)、曲面重组(CPR)和容积再现(VR)图像.比较IVU+CT与单纯IVU对上尿路病变的诊断能力.结果IVU+CT诊断正确62例,诊断符合率达95.4％.同期IVU检查的195例中确诊者124例(63.6％),两者有统计学意义(χ~2=29.4,P<0.05).IVU+CT对上尿路结石的敏感性、特异性分别为97.6％、91.3％,对上尿路病变定性诊断的敏感性、特异性分别为95.2％、100％；与此相对应,IVU的结果分别为59.0％、89.7％、70.8％和43.1％.结论 IVU+CT对上尿路病变的定位、定性诊断能提供更多的诊断信息,且相对省时省力,是对IVU的重要补充.“,”Objective To evaluate unenhanced helical CT following intravenous urography(IVU+CT)for detection of upper urinary tract(UUT)disease.Materials and Methods 195 patients with suspected urinary tract lesions underwent IVU examination.After the IVU,124 cases had confirmed diagnosis and 71 cases had uncertain diagnosis.Following CT scan were performed for the 65 patients with uncertain diagnosis(6 of the 71 patients quited voluntarily).CT data were transferred to the workstation for postprocessing.Results 62/65 cases(95.4%)had clear diagnosis using IVU+CT,while 124／195 cases(63.6％) were diagnosed by IVU.There Was significant difference between IVU and IVU+CT in the diagnosis of ureteral diseases(χ~2=30.3,P<0.05).Sensitivities of IUV+CT and IUV for diagnosing UUT lesions were 95.2％and 70.8％.specificities of IUV+CT and IUV were 100%and 43.1％.Conclusion IVU combined with CT provide more information for the diagnosis of UUT abnormalities and should be an important complement for IVU examination.