Ultrasound in functional GI disorders

Abstract

There are great advantages using ultrasound generating high temporal resolution enabling detailed imaging of dynamic sequences and local contractility with involvement of various GI wall layers, even compared to CT, MR, SPECT and PET imaging. The aim of this presentation is to show how advanced imaging can disclose organic and functional behaviour of the GI tract, often adding information about contractility, intestinal content and propulsion, meal distribution and accommodation of the stomach. Ultrasound of the stomach was initially performed to detect and investigate organic diseases of the gastric wall. Subsequently, different methods were developed to study functional aspects of gastric pathology. Ultrasound can be used to evaluate antral contractility, gastric emptying, transpyloric flow, gastric configuration, intragastric distribution of meals, gastric accommodation and strain of the gastric wall. Advanced methods for 3D ultrasound imaging and tissue Doppler (Strain Rate Imaging) have also been developed to study configuration and motility of the stomach. Furthermore, anaesthesiologists are now using ultrasound to estimate gastric content prior to surgery to assess risk of aspiration during the procedure. Moreover, adding contrast agents or elastography to the examination may further increase diagnostic yield. Ultrasound of the duodenum, jejunum, ileum and colon may also provide important clinical information about motility in diseases like coeliac, crohns, and GUCY-2C mutations.