What question did this study set out to answer?

The aim is to assess gastric motility and emptying using innovative real-time MRI and automated analysis techniques.

February 8, 2026Open Access

Quantitative Real‐Time MRI for the Assessment of Gastric Motility

Key Points

The aim is to assess gastric motility and emptying using innovative real-time MRI and automated analysis techniques.
Conducted a prospective study with healthy volunteers and Crohn's disease patients.
Participants ingested water and pineapple juice to evaluate fasting and postprandial motility.
Used 3T MRI with dynamic and static imaging sequences for assessment.
Analyzed gastric volumes and motility changes using Fourier transformation and AI-based segmentation.
Applied statistical models to analyze results and ensure significance.
Achieved high temporal resolution imaging at 6.24 frames per second.
Gastric emptying for water was rapid with a half-life of 14.77 minutes; for juice, it was slower at 64.24 minutes.
Contraction frequencies remained within normal ranges, showing little difference between fasting and fed states.
Workflow was effective in clinical settings, validated by measurements from patients.

Abstract

ABSTRACT Background Current reference standards for measuring gastric emptying and motility are not considered optimal due to the time required, ionizing radiation, invasiveness, and spatial resolution. Purpose To assess gastric motility using novel real‐time dynamic magnetic resonance imaging in combination with static measurements for gastric emptying and training of an automated deep‐learning‐based segmentation pipeline. Study Type Prospective. Participants The study included 36 healthy volunteers (20 female, mean 24 ± 3 years) and three patients with diagnosed Crohn's disease. Field Strength/Sequences Participants ingested water to assess fasting motility and pineapple juice for the postprandial state. 3 T, 3D spoiled gradient echo (GRE) sequence and real‐time spoiled GRE. Assessment Gastric emptying was measured by using the gastric volume, while motility was analyzed by tracking changes in the antrum's cross‐sectional area and applying Fast Fourier Transformation. Segmentations were performed using a trained semantic segmentation model. Statistical Tests Linear Mixed Model with continuous dependent variables and fixed effects. Models included a random intercept for participants. Statistical significance was defined as p = 0.05. Results The method enabled volumetric analysis of gastric content from 3D breath‐hold static acquisition and time‐resolved quantification of peristaltic parameters from real‐time FLASH2 imaging at high temporal resolution (here 6.24 fps). Water emptied rapidly and exponentially ( t 1/2 = 14.77 ± 10.55 min), while juice showed slower emptying ( t 1/2 = 64.24 ± 11.87 min). Contraction frequencies (fasted: 2.76 ± 0.43 cpm, fed: 2.89 ± 0.43 cpm) and velocities (fasted: 1.67 ± 0.38 mm/s, fed: 1.72 ± 0.37 mm/s) were within physiological ranges, with fasting conditions characterized by stronger occlusion compared to the fed. Measurements taken from three patients proved that the workflow could be used in a clinical context. Data Conclusion Real‐time MRI with AI‐based analysis enabled quantitative assessment of gastric emptying and motility, revealing physiological peristaltic parameters and state‐dependent differences in occlusion. Evidence Level 2. Technical Efficacy Stage 1.

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