目的:探讨口服等渗甘露醇行小肠CT造影(MSCTE)对肠管出血性疾病的诊断价值。方法:选取16例临床可疑消化道出血的患者。在进行肠道准备之后,分时段口服等渗甘露醇2000mL,采用0.62mm层厚及智能触发技术行动脉期、静脉期及延时期三期全腹扫描,并结合多平面重建(MPR)、最大密度投影(MIP)及容积再现(VR)技术对图像分析诊断。病例经手术、内镜或临床随访证实。结果:在16例中,小肠CT造影存在明确出血且与临床诊断出血部位一致8例,其中包括空肠出血3例,回肠出血2例,回盲部出血1例,升结肠出血1例,内痔出血1例;包括1例活动性出血;另有明确诊断出血原因4例,其中包括憩室出血1例,消化道间质瘤出血1例,小肠淋巴瘤出血1例及内痔1例,憩室出血经结肠镜证实,消化道间质瘤及小肠淋巴瘤经手术病理证实。小肠CT造影诊断存在出血,但出血部位与临床诊断不符1例。小肠CT造影与临床检查均未发现明确出血1例。小肠CT造影未发现明确出血灶,但临床证实出血6例。结论:口服等渗甘露醇行小肠CT造影检查结合图像后处理技术对于诊断消化道出血性疾病有一定价值。 Objective: To investigate the diagnostic value of oral isotonic mannitol in small intestine CT angiography (MSCTE) for diagnosis of intestinal bleeding disease. Methods: Sixteen patients with clinically suspected gastrointestinal bleeding were selected. After intestine preparation, sublingual osmotic mannitol (2000mL) was orally administered in different time periods. Three stages of full-abdominal scanning including arterial, venous and delayed phases were performed with 0.62mm layer thickness and smart trigger technique. Combined with multiplanar reconstruction (MPR) MIP and VR techniques for image analysis and diagnosis. Cases were confirmed by surgery, endoscopy or clinical follow-up. Results: In 16 cases, small intestine CT angiography had definite bleeding and consistent with the clinical diagnosis of bleeding site in 8 cases, including jejunal hemorrhage in 3 cases, ileal hemorrhage in 2 cases, ileocecal hemorrhage in 1 case, ascending colon bleeding in 1 case, hemorrhoids hemorrhage 1 case; including 1 case of active bleeding; another 4 cases of a clear diagnosis of bleeding causes, including diverticular bleeding in 1 case, gastrointestinal stromal tumor in 1 case, 1 case of intestinal lymphoma hemorrhoids and hemorrhoids in 1 case, diverticular bleeding through the colon Mirror confirmed that gastrointestinal stromal tumors and small intestinal lymphoma confirmed by surgical pathology. Intestinal CT angiography diagnosis of bleeding, but the bleeding site does not match with the clinical diagnosis of a case. Small bowel CT angiography and clinical examination did not find a clear case of bleeding. Intestinal CT angiography did not find a clear hemorrhage, but the clinical confirmed hemorrhage in 6 cases. Conclusion: Oral osmotic mannitol small intestine CT angiography combined with image post-processing technology for the diagnosis of gastrointestinal bleeding disease has a certain value.