MRI for the evaluation of gastric physiology

Abstract

Background:Evaluation of gastric physiology (gastric emptying and motility) is important for the diagnosis of disturbances such as functional dyspepsia. MRI is a non-invasive technique that allows simultaneous registration of gastric emptying and motility.Aim:To provide an overview of the literature of studies that used MRI as a tool for evaluation of gastric function in both research and clinical settings.Materials and methods:A MEDLINE search was performed (1990–2008) directed at the radiology and gastroenterology literature on gastric physiology. Key words that were used included: functional tests, gastric emptying, gastric motility, gastric physiology and MRI. Twenty-five articles fulfilled the inclusion criteria and were included in the analysis.Results and conclusion:Over the last decade, MRI has developed as a reliable, non-invasive method for detailed evaluation of gastric emptying and motility without the disadvantages of ionizing radiation and without the use of intragastric catheters that influence gastric physiology.

Measurement of gastric emptying by radiopaque markers in patients with diabetes: correlation with scintigraphy and upper gastrointestinal symptoms

“…However, so far these techniques are not widely used in clinical practice, even though they all show adequate sensitivity and specificity to define patients with gastroparesis. Ultrasonography, even though widely available, has the disadvantage of being very operator dependent, 16 and assessment of gastric emptying with magnetic resonance imaging has so far been limited by the specialized equipment and expense 42 . Gastric emptying breath tests has mainly been used in clinical studies and in a few European centers, but is not available for clinical use in the US, even though the correlation with scintigraphy is good, 16,43 and the wireless motility and pH capsule, Smart pill, 44 has only recently become available in Europe.…”

Electrogastrography in Adults and Children: The Strength, Pitfalls, and Clinical Significance of the Cutaneous Recording of the Gastric Electrical Activity

“…The results are reproducible and correlate with scintigraphic GE results [145]. Besides, MRI has developed as another noninvasive method for detailed evaluation of GE, motility, and volume without the disadvantages of ionizing radiation and without the use of intragastric catheters that influence gastric physiology [146, 147]. Several peptides have been demonstrated to be involved in the onset and/or modulation of the dysrhythmias in several experimental models.…”

Gastric emptying and glycaemia in health and diabetes mellitus

“…124 Findings using MRI correlate well with those obtained by scintigraphy for the measurement of gastric emptying, but high cost, limited availability and long duration of image capture dictate that this method is generally reserved for research protocols. 117,126,127 Acetaminophen absorption testing is a noninvasive, and hitherto widely used, test of gastric emptying; however, this method has not been well validated against scintigraphy and cannot be recommended as an accurate measure of gastric empty ing. 117,128 Furthermore, although the vagal component of visceral autonomic neuropathy can be evaluated by measuring levels of pancreatic polypeptide during insulin-induced hypoglycaemia, 129,130 routine use of this method in the diagnostic workup of patients with diabetic gastroparesis cannot be recommended.…”