Pregnancy is associated with a fivefold increase in the prevalence of venous thromboembolism, and pulmonary embolism is a leading cause of maternal death. However, the diagnosis of pulmonary embolism during pregnancy is challenging because classic clinical symptoms are often absent and physiologic changes during pregnancy can mimic pulmonary embolism. Concerns about exposure of the fetus to ionizing radiation and intravenously administered contrast material, as well as potential medicolegal issues, further complicate the diagnosis. Although diagnostic imaging plays an important role in this setting, there are currently no widely accepted guidelines for radiologists and clinicians to follow. Thus, radiologists should be familiar with the advantages and disadvantages of available imaging modalities, methods for dose reduction, radiation risks, and medicolegal risk management guidelines.

Objective-The purpose of this study was to evaluate the importance of echogenic material in the fetal frontal horns.Methods-This was a Health Insurance Portability and Accountability Act-compliant, Institutional Review Board-approved retrospective study. In part 1 of the study, prenatal sonography, prenatal magnetic resonance imaging (MRI), and birth outcomes of 17 fetuses (mean gestational age, 19 weeks; range, 15-34 weeks) with prospective echogenic material in the frontal horns were assessed. In part 2, 400 consecutive sonographic fetal surveys (mean gestational age, 19 weeks; range, 15-38 weeks) were reviewed to determine the incidence. In part 3, 2 independent reviewers assessed the appearance of the frontal horns in 40 fetuses (20 with suspected intraventricular hemorrhage from parts 1 and 2 and 20 who were interpreted to have normal findings in part 2).

In a pre-employment setting, one PA radiograph is sufficient for TB screening of individuals with positive PPD skin test results. Elimination of the acquisition of lateral radiographs would substantially reduce radiation exposure.

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