Back to basics: imaging in pregnant women

Congress:

ECR 2018

Poster Number:

C-0324

Type:

Educational Exhibit

Keywords:

Obstetrics (Pregnancy / birth / postnatal period), Ultrasound, CT, MR, Diagnostic procedure, Education, Radiation safety, Quality assurance, Patterns of Care

Authors:

M. A. Serrado¹, N. N. Abreu¹, G. M. F. Castanha²; ¹Funchal/PT, ²9004/PT

DOI:

10.1594/ecr2018/C-0324

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-0324

Fig. 1: Figure 1: Adjustable technical CT parameters.

Fig. 2: Figure 2: Summary of the potential radiation effects to the foetus. Table is...

Fig. 3: Figure 3. Summary of the radiation doses of the most frequent imaging studies....

Fig. 4: Figure 4: Suggested algorithm to investigate acute trauma in pregnant patients.

Fig. 5: Figure 5: Suggested algorithm to investigate acute appendicitis in pregnant...

Learning objectives

To discuss about imaging modalities available for evaluating pregnant women. To make a brief review about the effects of ionizing radiation. To address the main indications for several clinical scenarios.

Background

The safety of diagnostic imaging in pregnant women is a recurrent and relevant concern but often confusing and controversial. The awareness of radiation risks in imaging pregnant women is lower than expected among radiologists and clinicians. The use of imaging in pregnant patients is increasing.

Findings and procedure details

We have searched indexed publications in scientific repositories such as Medline and Pubmed for current data, using keywords like “imaging”, “pregnancy” and “guidelines”. 1. Imaging modalities Two basic principles should be used when imaging pregnant patients: · Non-ionizing imaging modalities, such as ultrasound (US) and magnetic resonance (MR), are preferable when equivalent in accuracy to imaging that involves ionizing radiation; · When ionizing radiation is used for imaging, the cumulative uterine dose should be kept as low as reasonably achievable (ALARA). Radiography Foetal radiation exposure...

Conclusion

Although imaging modalities that do not use ionizing radiation are preferred, no evaluation should be postponed when an important clinical diagnosis is suspected. The radiologist should participate in the choice of the best imaging modality and is responsible for optimizing the protocol. The risk to a foetus from ionizing radiation is dependent on the gestational age at the time of exposure and the dose of radiation.

Personal information

References

· Tirada N, Dreizin D, Khati NJ, Akin EA, Zeman RK. Imaging Pregnant and Lactating Patients. RadioGraphics, 2015, 35:1751-65 · American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Committee Opinion No. 656: Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2016, 127:75-80 · Wieseler KM, Bhargava P, Kanal KM, Vaidya S, Stewart BK, Dighe MK. Imaging in Pregnant Patients: Examination Appropriateness. RadioGraphics, 2010, 30:1215-33 · Wang PI, Chong ST, Kielar AZ, Kelly UD, Mazza MB, Goodsitt MM. Imaging of Pregnant and...