Evaluation of gastric emptying in patients with gastroparesis by three-dimensional ultrasound

BACKGROUND: To diagnose gastroparesis, it is necessary to assess gastric emptying accurately. This study aims to investigate the role of three-dimensional ultrasonography (3-D US) on the measurement of gastric volume to evaluate gastric accommodation in healthy patients. METHODS: In this study, 21 volunteers, 46 patients with diabetic gastroparesis (DG), and 22 patients with postsurgical gastroparesis (PSG) underwent 3-D US after oral administration of 250 mL gastrointestinal contrast at 2, 30, 60, and 90 min. The volume of the contrast agent in the stomach was then calculated using the virtual organ computer-aided analysis (VOCAL) (Virtual Organ Computer-aided AnaLysis, General Electric Medical Systems, Kretztechnik, Zipf, Austria). RESULTS: In the DG group, the gastric residue volumes at postprandial 60 and 90 min were significantly higher than those in the healthy group (P<0.05), and the areas under the receiver operating characteristic (ROC) curve of these parameters were 0.830 and 0.957, respectively. There were significant differences between the PSG and healthy groups at 60 and 90 min; however, the AUC of gastric residue at 90 min (0.955) was higher than the AUC at 60 min (0.697). CONCLUSIONS: Therefore, this study showed that the 3-D US is a powerful tool for assessing gastric emptying and provides a new strategy for diagnosing gastroparesis.