目的:探讨n 99Tcn m－二巯基丁二酸(DMSA)肾SPECT/CT显像对成人上尿路感染的诊断价值。n 方法:回顾性分析2017年9月至2019年12月间北京医院109例临床疑诊上尿路感染患者[男14例，女95例，年龄23～85(60.0±14.1)岁]的n 99Tcn m－DMSA肾SPECT/CT显像及临床资料，以临床最终诊断作为诊断标准，分析n 99Tcn m－DMSA肾SPECT/CT显像的诊断效能，并与SPECT显像结果比较；另分析上尿路感染的SPECT/CT影像表现。采用n χ2检验或Fisher确切概率法比较不同诊断方法间的差异。n 结果:109例患者中n 99Tcn m－DMSA肾SPECT/CT显像诊断上尿路感染91例，其诊断上尿路感染的灵敏度、特异性、阳性预测值、阴性预测值及准确性分别为100%(86/86)、78.26%(18/23)、94.51%(86/91)、18/18、95.41%(104/109)；同机低剂量CT的应用使SPECT/CT显像的诊断特异性明显高于SPECT显像[52.17% (12/23)，n P＝0.014]，并有5.81%(5/86)的患者借助于同机CT发现了上尿路感染的病因。29.41%(10/34)的慢性肾盂肾炎患者SPECT/CT显像可见典型肾瘢痕征象；剔除典型肾瘢痕患者后，急性、慢性肾盂肾炎患者肾放射性减低或缺损区≤2个者分别为11.54%(6/52)和37.50%(9/24)，差异有统计学意义(n χ2＝6.987，n P＝0.008)。n 结论:99Tcn m－DMSA肾SPECT/CT显像对成人上尿路感染的诊断具有良好的临床应用价值。与n 99Tcn m－DMSA肾SPECT显像相比，SPECT/CT显像能有效提高特异性，探查尿路梗阻、结石等上尿路感染病因。n “,”Objective:To explore the diagnostic value of n 99Tcn m-dimercaptosuccinic acid (DMSA) renal SPECT/CT imaging in adult upper urinary tract infection.n Methods:From September 2017 to December 2019, n 99Tcn m-DMSA renal SPECT/CT imaging and clinical data of 109 patients (14 males, 95 females; age: 23-85(60.0±14.1) years) suspected of upper urinary tract infection from Beijing Hospital were retrospectively analyzed. Final clinical diagnosis was regarded as the diagnostic standard. The diagnostic efficacy of n 99Tcn m-DMSA renal SPECT/CT imaging was analyzed and compared with that of n 99Tcn m-DMSA renal SPECT imaging. The imaging features of SPECT/CT imaging in upper urinary tract infection were analyzed. The differences between the diagnostic methods were analyzed by using n χ2 test or Fisher′s exact test.n Results:Of 109 patients, 91 were diagnosed as upper urinary tract infection by n 99Tcn m-DMSA renal SPECT/CT imaging, with the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 100%(86/86), 78.26%(18/23), 94.51%(86/91), 18/18 and 95.41%(104/109), respectively. With the application of low-dose CT, the diagnostic specificity of SPECT/CT was significantly higher than that of SPECT (52.17% (12/23); n P=0.014), and the causes of upper urinary tract infection were found in 5.81% (5/86) of patients with the help of CT. There were 10 (29.41%, 10/34) patients with chronic pyelonephritis had typical signs of renal scar on SPECT/CT imaging. Excluding the patients with typical renal scar, 11.54% (6/52) and 37.50% (9/24) of patients with acute and chronic pyelonephritis had decrease or defect focus≤2 (n χ2=6.987, n P=0.008).n Conclusions:99Tcn m-DMSA renal SPECT/CT has good clinical value in the diagnosis of adult upper urinary tract infection. Compared with n 99Tcn m-DMSA renal SPECT, n 99Tcn m-DMSA renal SPECT/CT can effectively improve the diagnostic specificity and explore the causes of upper urinary tract infection such as urinary tract obstruction and stones.n