MRI ‐Based Gastric Function Assessment in Patients With Functional Dyspepsia

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BACKGROUND: Magnetic resonance imaging (MRI) enables non-invasive, radiation-free assessment of gastric emptying, intragastric liquid distribution, and motility. However, characterization of the stomach function in patients with functional dyspepsia (FD) remains limited. We aimed to apply the Virtual Gaster (VIGA) MRI platform to characterize gastric geometry, emptying dynamics, and motility patterns in patients with FD compared with healthy controls (HCs). METHODS: Twenty-six adults with Rome IV-defined FD and twenty HCs underwent static and dynamic gastric MRI during fasting, gastric filling with a liquid meal, and emptying. VIGA was used to quantify compartmental gastric volumes (fundus, corpus, antrum), estimate gastric half-emptying time (T50), and assess motility parameters. Symptoms were evaluated using PAGI-SYM and postprandial visual analog scales. RESULTS: Gastric half-emptying time was shorter in FD than in HCs (47.7 ± 27.8 vs. 68.0 ± 15.7 min; p = 0.008). FD patients showed reduced fundic content volumes with a relative shift of content toward the corpus and antrum (p < 0.05). Gastric dysrhythmias were more frequent in FD (50% vs. 10%; p = 0.006), and distal contraction propagation with rhythmic activity was slower during both accommodation (3.19 ± 0.83 vs. 4.10 ± 1.21 mm/s; p = 0.001) and emptying (3.31 ± 0.61 vs. 3.93 ± 1.02 mm/s; p = 0.01). Exploratory analyses showed moderate inverse correlations between symptom severity, particularly bloating and heartburn, and antral volume or contraction velocity during accommodation. CONCLUSIONS: VIGA-enabled gastric MRI identified differences in intragastric liquid distribution, gastric liquid emptying, and distal motility between FD patients and healthy controls. The moderate correlation with symptoms supports its value for characterizing regional gastric physiology in health and disease.

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