Evaluation of gastric peristalsis using cine MRI in healthy subjects and patients with functional dyspepsia

Introduction: Functional dyspepsia (FD) is subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), each with a different pathophysiological mechanisms driving the symptoms of these syndromes. Cine MRI aids observation in any continuous cross-section and measures gastrointestinal peristalsis without radiation exposure. In this study, we aimed to evaluate gastric peristalsis in FD using cine MRI. Methods: This study was a prospective interventional study. Patients diagnosed with FD according to ROME IV diagnostic criteria were included. Cine MRI was performed before and after the test meal. Gastric maximum short axis diameter, amplitude, contraction frequency, peristaltic wave height, peristaltic wave velocity, and gastric motility index (GMI) were evaluated and compared between healthy control (HC) and FD (PDS/ EPS) patients. Results: This study consisted of 18 HC and 31 FD patients (including 22 with PDS and 9 with EPS). Pre-prandial comparison of the HC, PDS, and EPS groups showed no significant difference. Post-prandial comparison of the three groups showed significant differences in maximum short axis diameter of fornix (HC: 51.5±9.1/ PDS: 47.1±10.3/ EPS: 59.0±13.6 mm, p=0.045), amplitude of fornix (HC: 7.3±5.1/ PDS: 12.1±4.3/ EPS: 11.3±8.7 mm, p=0.009), contraction frequency (HC: 2.9±0.3/ PDS: 2.7±0.5/ EPS: 2.6±0.2 times/min, p=0.007), peristaltic wave height (HC: 14.9±4.0/ PDS: 9.2±2.5/ EPS: 9.5±3.2 mm, p<0.001), and GMI (HC: 24.5±7.1/ PDS: 16.8±6.1/ EPS:15.9±6.3 mm 2 /s, p=0.002). Discussion: Cine MRI can be used to visually evaluate gastric peristalsis dysfunction and impaired gastric accommodation in FD.