Naringrekar Haresh V, Gupta Avneesh, Fidler Jeff L, Dane Bari, Cahalane Alexis M, Wells Mike L
Thomas Jefferson University Hospital, Philadelphia, USA.
Boston University, Boston, USA.
Abdom Radiol (NY). 2025 Jun 28. doi: 10.1007/s00261-025-05065-w.
The evaluation of patients with gastrointestinal (GI) bleeding is complicated due to the variety of tests available and the large number of potential causes of bleeding. MRI is less commonly used than computed tomography and endoscopy but it can diagnose disease that causes GI bleeding and serve as a complementary role to other tests. MRI is most often used in the form of magnetic resonance enterography (MRE) to assess patients with suspected bleeding from the small bowel. While CT enterography (CTE) and video capsule endoscopy (VCE) are the more commonly used tests in the setting of GI Bleeding, MRE has characteristics which may make it the more favorable modality for a given patient. Potential advantages of MRE, protocol considerations and the literature delineating its diagnostic performance for detecting pathology which can cause GI bleeding relative to CTE and VCE are reviewed here. MRI is uncommonly used to assess patients with upper GI bleeding, lower GI bleeding and patients with bleeding sites that remain undetected despite a formal evaluation of the GI tract, however it may add value in specific clinical scenarios. These uncommon scenarios and specific clinical examples are also presented to highlight the potential benefits of MRI.
由于可用检查种类繁多以及胃肠道（GI）出血的潜在病因众多，对GI出血患者的评估较为复杂。与计算机断层扫描和内窥镜检查相比，MRI的使用频率较低，但它可以诊断导致GI出血的疾病，并作为其他检查的补充手段。MRI最常以磁共振小肠造影（MRE）的形式用于评估疑似小肠出血的患者。虽然CT小肠造影（CTE）和视频胶囊内镜检查（VCE）是GI出血情况下更常用的检查，但MRE具有的一些特征可能使其成为特定患者更有利的检查方式。本文回顾了MRE的潜在优势、方案考量以及描述其相对于CTE和VCE检测可导致GI出血的病变的诊断性能的文献。MRI很少用于评估上消化道出血、下消化道出血以及尽管对胃肠道进行了正式评估但出血部位仍未被发现的患者，然而在特定临床场景中它可能会增加价值。本文还介绍了这些不常见的场景和具体临床实例，以突出MRI的潜在益处。
