MR Imaging of Abdominal and Pelvic Pain in Pregnancy

April A. Bailey, MD; Ivan Pedrosa, MD; Diane M. Twickler, MD, FACR; Neil M. Rofsky, MD

Disclosures

Appl Radiol. 2012;42(9):16-24. 

In This Article

Abstract and Introduction

Introduction

Imaging frequently guides patient management in the evaluation of pelvic pain. When the patient is also pregnant, the source of the patient's pain is often clinically confounded. An accurate imaging diagnosis is important, since surgical and medical management decisions often rely on those findings. However, the anatomic and physiologic changes associated with pregnancy pose substantial challenges to the interpreting radiologist. Ultrasound should be used as initial evaluation given its lack of ionizing radiation and wide availability. When ultrasound evaluation is equivocal or limited, cross-sectional imaging is often requested typically with computed tomography (CT).

With a heightened awareness of radiation exposure and faster, motion immune sequences, magnetic resonance (MR) imaging is being used with increased frequency.[1–5] MR of the abdomen with a gravid uterus displacing familiar anatomy can be challenging for the otherwise seasoned radiologist well versed in cross-sectional imaging.[1] In this review, we will present practical applications of MR in the pregnant patient with pelvic pain, knowing that rapid diagnosis and prompt treatment is of the utmost importance in this population.[6]

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