Objective To compare the image quality of dual-energy virtual non-contrast-enhanced (VNC) and true noncontrastenhanced CT image (TNC) of the upper abdomen, and explore the feasibility of VNC instead of TNC. Methods Dual-energy CT was used to perform contrast-enhanced scans of upper abdomen in 37 patients, in which the plain scan was in single-energy mode, and dual-energy mode was used for arterial and venous phase scanning. The post-processing software Liver-VNC was used to obtain VNC of arterial and portal venous scan images (VNCA, VNCV), compared with CT value, signal to noise ratio (SNR), image score, lesion detection rate and radiation dose of liver, spleen, pancreas and erector spinae muscle in the three groups of TNC, VNCA, and VNCV images. Results There were significant difference between the CT values, SNR and noise of liver, spleen, pancreas and erector spinae between TNC and VNCA and VNCV (P<0.05). And there was no significant difference between VNCA and VNCV, the CT values between VNCA and VNCV (liver P=0.151丨 spleen P=0.644丨 pancreas P=0.399丨 erector spinae P=0.558), SNR (liver P=0.568丨 spleen P=0.922丨 pancreas P=0.628丨 verticalSpinal muscle P=0.745), noise (liver P=0.856丨 spleen P=0.983丨 pancreas P=0.515丨 erector spinae P=0.745)丨 there were no significant difference between the radiation dose (P=0.286) in the three groups of TNC, VNCA, and VNCV images, but there were significant difference between the total radiation dose (P<0.001) in traditional enhanced scanning mode and dual-energy scanning mode丨 the scores of the three-phase images of TNC, VNCA, and VNCV were not statistically significant (P=0.701)丨 the detection rates of the three-phase images of TNC, VNCA, and VNCV were 82.2%, 81.5%, 80.8%, χ2=0.091, P=0.956, showed no significant difference. Conclusion The VNC of the upper abdomen can basically replace the TNC, besides, it can reduce one phase radiation dose, which has a great advantage in returning patients.