Di Ciaula Agostino, Khalil Mohamad, Portincasa Piero
Clinica Medica "Augusto Murri" - AOUC Policlinico, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
Consortium of Mediterranean Universities, Rome, Italy.
Intern Emerg Med. 2025 Feb 27. doi: 10.1007/s11739-025-03905-7.
The diagnosis of functional disorders of the upper gastrointestinal tract relies on clinical evaluation after exclusion of most frequent organic diseases. Diagnostic techniques contribute to better characterization of disease, choice of specific therapy, and follow-up. Functional ultrasonography was introduced in the early '80 s for the non-invasive study of gastric and gallbladder emptying without ionizing radiation, during fasting and postprandially. This technique detects dysfunctional motility in several gastrointestinal and systemic conditions, and can be used along with the assessment of real-time satiety and gastrointestinal symptoms after food ingestion, and dosing of hormones involved in the modulation of gastrointestinal and metabolic homeostasis. Functional ultrasonography has been increasingly used to explore the gastrointestinal pathophysiology, the gut-brain interaction, the effects of drugs (such as antidiabetics), the response to specific dietary and feeding patterns, and to support the development of nutraceuticals. In this evolving scenario, ultrasonography stands as a widely available, highly sustainable, non-invasive, repeatable, safe and low-cost tool, as compared with more expensive, less sustainable or still scarcely standardized procedures to study gastric and gallbladder motility as scintigraphy, wireless motility capsule tests, C breath tests, or magnetic resonance imaging. Functional ultrasonography not only provides reliable data in experimental protocols, but also in the assessment of clinical conditions as dyspeptic symptoms, diabetes, gastroenteric and neurological diseases, critical illness, and as a benchmark to evaluate the gastrointestinal effects of innovative drugs.
上消化道功能紊乱的诊断依赖于在排除最常见的器质性疾病后进行临床评估。诊断技术有助于更好地对疾病进行特征描述、选择特定治疗方法以及进行随访。功能超声检查于20世纪80年代初被引入，用于在禁食和餐后对胃和胆囊排空进行无创研究，且无电离辐射。该技术可检测多种胃肠道和全身性疾病中的运动功能障碍，并可与进食后实时饱腹感和胃肠道症状的评估以及参与调节胃肠道和代谢稳态的激素剂量测定一起使用。功能超声检查越来越多地用于探索胃肠道病理生理学、肠脑相互作用、药物（如抗糖尿病药物）的作用、对特定饮食和喂养模式的反应，以及支持营养保健品的开发。在这种不断发展的情况下，与用于研究胃和胆囊运动的更昂贵、可持续性较差或仍未充分标准化的程序（如闪烁扫描、无线动力胶囊测试、C呼气试验或磁共振成像）相比，超声检查是一种广泛可用、高度可持续、无创、可重复、安全且低成本的工具。功能超声检查不仅在实验方案中能提供可靠数据，而且在评估消化不良症状、糖尿病、胃肠和神经疾病、危重病等临床情况时也能提供可靠数据，还可作为评估创新药物胃肠道效应的基准。
