Imaging

Gastroparesis

Preliminary Diagnosis: Gastroparesis

I. What imaging technique is first-line for this diagnosis?

Contrasted fluoroscopic upper GI examination

II. Describe the advantages and disadvantages of this technique for diagnosis of gastroparesis.

Advantages

  • Highly portable examination

Disadvantages

  • Has limited sensitivity and is poorly specific in detailing gastroparesis compared to a nuclear medicine gastric emptying test

  • May expose patients to a large amount of radiation

  • Highly operator dependent

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

  • Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of gastroparesis.

Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

Advantages

  • Gold standard for diagnosis of gastroparesis

  • Highly sensitive and specific in detailing gastroparesis

Disadvantages

  • Time-consuming and must be performed over 4 hours

  • Radiopharmaceuticals may not be given to pregnant patients or those breastfeeding

  • Offers limited evaluation of the surrounding anatomic structures

VI. What are the contraindications for the alternative imaging techniques?

Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

  • May not be given to pregnant patients or those breastfeeding

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