What are the risks of an MRI in the management of neurologic disease during pregnancy?

Updated: Aug 20, 2019
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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With regard to magnetic resonance imaging (MRI) during pregnancy in the research setting, in which participation is entirely voluntary and optional, the Johns Hopkins Medicine Internal Review Board has stated that “MRI imaging [sic] is not known to cause risk to the developing fetus though there may be risks that are not known at this time. MRI contrast is known to cross the placenta and subsequent risks to the developing fetus are not known.” (See Magnetic Resonance Imaging Standard Language for Consent Documents.)

Such language also appears to be adequate in the clinical setting when the indication for the study is clearly articulated and the risk of failure to diagnose is weighed against the unknown and hitherto undemonstrated risk to the developing fetus.

In addition, the risk associated with MRI in a particular clinical situation must be weighed against the risk associated with alternative imaging modalities using ionizing radiation. The chief concern is that an adverse outcome may occur that is unrelated to MRI but will be attributed to imaging. This risk may be minimized by appropriately documenting the indications for the test, discussing the benefits and risks with the patient, and obtaining the patient’s consent to testing.

Similar considerations apply to the clinical use of magnetic resonance angiography (MRA) or magnetic resonance venography (MRV) during pregnancy. The benefits of the information that may be gained from MRA or MRV must be weighed against the understanding that even though no risks are currently documented for these procedures, significant radiation-related risks are documented for alternative testing modalities (eg, conventional angiography and computed tomographic angiography [CTA]).

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