Purpose To analyze the relationships between glomerular filtration rate (GFR) measured by SPECT and renal parenchyma thickness and enhanced CT value measured by CT, and to explore predictive significance of CT in evaluating renal function of patients with hydronephrosis.Materials and Methods One hundred and fifteen patients diagnosed with unilateral hydronephrosis by ultrasound were retrospectively analyzed. GFR% (GFR percentage of affected kidney to the both kidneys) was measured by SPECT. CT% (percentage of affected renal parenchyma thickness to the both kidneys) and enhanced CT% (percentage of enhanced CT value of affected kidney to the both kidneys) were measured by pre- and post-contrast CT scan. According to GFR, the renal function was divided into mild-to-moderate impairment, severely impairment and non-function. Twenty-five volunteers were recruited as control group. CT%, enhanced CT% and GFR%among the four groups were compared, and the correlation of CT% and enhanced CT%with GFR% was analyzed to evaluated CT in predicting renal function.Results CT%, enhanced CT% and GFR% in mild-to-moderate impairment group was significantly greater than those in severely impairment group and non function group (F=20.24, 7.78 and 329.21,P<0.05). GFR% was positive correlated with CT% (r=0.58,P<0.05) and enhanced CT% (r=0.61,P<0.05). Area under curve (AUC) of CT% were 0.54, 0.79 and 0.83 for mild-to-moderate impairment, severely impairment and non-function, with sensitivity of 92.91%, 93.47%, 65.72%, and specificity of 35.33%, 59.47%, and 88.62%, respectively. AUC of enhanced CT% were 0.79, 0.89 and 0.96 for the three groups, with sensitivity of 97.51%, 80.02%, 97.66%, and specificity of 58.14%, 89.82% and 94.27%, respectively.Conclusion There was high correlation between renal function imaging by SPECT and CT in evaluating renal function of hydroneohrosis patients. Pre- and post-contrast CT scan can be used as complements in predicting renal function, and post-contrast CT with high accuracy.%目的：分析SPECT肾小球滤过率（GFR）与CT测得肾实质厚度及增强CT值之间的关系，探讨CT对不同程度肾积水患者肾功能的预测价值。资料与方法回顾性分析115例经超声确诊为单侧肾积水的患者，经SPECT测得患肾的GFR占总肾GFR百分比（GFR%）与CT平扫测得患肾占双肾实质厚度百分比（CT%）、患肾增强CT值占双肾增强CT值百分比（增强CT%）。按患肾GFR分为轻中度受损、重度受损、无功能，以25例健康志愿者作为对照。比较各组CT%、增强CT%及GFR%，并分析其相关性，评价CT预测肾功能的价值。结果轻中度受损组CT%、增强CT%及GFR%均显著大于重度受损组及无功能组（F=20.24、7.78、329.21，P<0.05）。CT%、增强CT%与GFR%呈正相关（r=0.58、0.61，P<0.05）。轻中度受损组、重度受损组、无功能组ROC评价CT%曲线下面积分别为0.54、0.79、0.83，敏感度分别为92.91%、93.47%、65.72%，特异度分别为35.33%、59.47%、88.62%；3组ROC评价增强CT%曲线下面积分别为0.79、0.89、0.96，敏感度分别为97.51%、80.02%、97.66%，特异度分别为58.14%、89.82%、94.27%。结论SPECT肾功能显像与CT扫描对肾积水功能评价有良好的相关性，CT平扫及增强扫描可以作为预测肾积水患者肾功能受损程度的补充指标。增强CT%预测的准确性较高。
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