Radiological Imaging in Gastroparesis: A Narrative Literature Review of Diagnostic and Evaluation Techniques

Gastroparesis is a gastrointestinal disorder characterised by delayed gastric emptying without mechanical obstruction, leading to symptoms such as nausea, vomiting, bloating, and epigastric discomfort. Accurate diagnosis and evaluation of this condition are critical, as untreated gastroparesis can result in complications including malnutrition, electrolyte imbalances, and mucosal injury. Radiological imaging plays a central role in both diagnosing and assessing the severity of gastroparesis. This narrative review provides an overview of current imaging modalities, including gastric emptying scintigraphy (GES), barium studies, gastric emptying of radiopaque markers, transabdominal ultrasound, and magnetic resonance imaging (MRI). GES remains the gold-standard diagnostic tool due to its quantitative assessment of gastric emptying, though limitations such as cost, time requirements, radiation exposure, and limited accessibility may restrict its use. Alternative modalities, including ultrasound and MRI, offer noninvasive, safer, and increasingly accurate options, with MRI showing promising correlations with GES in measuring gastric motility and emptying. Barium studies and radiopaque markers play complementary roles in ruling out obstruction or providing screening. Understanding the strengths and limitations of these imaging techniques can guide clinicians in selecting appropriate diagnostic strategies and improve patient management in gastroparesis.