男性，42岁，活动多时常出现右腰部钝痛。尿常规检查：红细胞15 ~ 20个/高倍视野，白细 胞3 ~5个/高倍视野。B超：肾盂内可见 3cm x2cm不规则形弱强回声，其后不伴声影。为明确诊断首先选择的检查是

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